RESUMEN
INTRODUCCIÓN: La anticoncepción hormonal, a través de implantes subdérmicos, es uno de los métodos anticonceptivos reversibles de larga duración más eficaces en la actualidad que está disponible en nuestro país en forma gratuita en el sistema público. OBJETIVO: Reconocer los efectos adversos y los motivos de retiro del Implante Jadelle® en usuarias del Hospital de Clínicas, así como evaluar la información recibida por las usuarias al momento de la colocación. MATERIAL Y MÉTODOS: Un total de 160 pacientes participaron en el estudio a través de una encuesta previo consentimiento informado. Se utilizó la estadística descriptiva en números absolutos y porcentuales. Resultados: Previo al uso, recibieron información sobre los probables efectos adversos del método el 83% de ellas, y acerca de la efectividad del método el 89 %. En cuanto a efectos adversos los presentaron el 80,6% de las usuarias, siendo la irregularidad de la menstruación la causa más frecuente constituyendo un 61%. CONCLUSIONES: Es alta la frecuencia de pacientes que presentan efectos adversos y que solicitan retiro del implante antes del tiempo a causa de ello, 35% de las usuarias, siendo el principal motivo la irregularidad menstrual en un 43% de los casos. Es recomendable realizar un correcto asesoramiento previo a la colocación e incentivar a las pacientes a concurrir a los controles médicos, luego de la colocación, para brindar asesoramiento y tratamiento si se presentara algún efecto adverso, con el fin de obtener una mejor continuidad de uso del método.
INTRODUCTION: Hormonal contraception, through subdermal implants, is one of the most effective long active reversal contraceptive methods currently available in our country for free in the public system. OBJETIVE: Recognize the adverse effects and the reasons for its withdrawal in users of the Hospital de Clínicas as well as to evaluate the information received by the users at the time of placement. METHODOLOGY: A total of 160 patients participated in the work with prior informed consent through a survey. Descriptive statistics were used in absolute and percentage numbers. They received information on the probable adverse effects of the 83% pre-use method, about the effectiveness of the 89% method. RESULTS: Regarding adverse effects, they were present in 80.6% of the users; the being irregularity of menstruation is the most frequent, constituting 61%. Concluding that the frequency of patients presenting with adverse effects and requesting removal of the implant before the time is high because of it, 35% of the users who requested removal menstrual irregularities were the main reason for 43% of patients. CONCLUSIONS: It is advisable to make a correct advice prior to placement and encourage patients to attend medical controls, after placement, to provide advice and treatment if any adverse effect occurs, in order to give better use in terms of method time.
Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Adulto Joven , Anticonceptivos Femeninos/efectos adversos , Remoción de Dispositivos , Implantes de Medicamentos/efectos adversos , Progesterona/administración & dosificación , Progesterona/efectos adversos , Estudios Transversales , Encuestas y Cuestionarios , Levonorgestrel/administración & dosificación , Levonorgestrel/efectos adversos , Anticoncepción/métodos , Anticonceptivos Femeninos/administración & dosificación , MotivaciónRESUMEN
OBJECTIVE: To assess the adherence of healthcare providers to cesarean-delivery techniques before and after the introduction of a technique checklist at a university hospital. METHODS: A retrospective cross-sectional cohort study included data from all cesarean deliveries at Gynecology Clinic B of the University of the Republic, Montevideo, Uruguay, between January 1 and December 31, 2011. The data were grouped based on whether delivery occurred before or after the implementation of the checklist and were compared across a range of cesarean-delivery techniques. RESULTS: Data from 296 cesarean deliveries were included; 130 from before implementation and 166 from after. After the implementation of the checklist, complete adherence to all techniques was observed in 28 (16.9%) deliveries. Following the introduction of the checklist, the odds of prophylactic cefazolin (OR 8.35, 95% CI 3.74-20.9), chlorhexidine (OR 8.98, 95% CI 3.72-23.7), cord traction for the third stage of labor (OR 2.26, 95% CI 1.33-3.85), and double-layer hysterorrhaphy (OR 3.65, 95% CI 2.09-6.55) being properly applied increased compared with before the implementation of the checklist. CONCLUSIONS: Overall adherence to the prescribed techniques was low. The implementation of this checklist improved the odds of several techniques being applied by between two- and eight-fold.
