Characteristics and contraceptive practices among Chinese women seeking abortion: a multicentre, descriptive study from 2019 to 2021.

INTRODUCTION: Despite the widespread provision of free contraceptives and post-abortion care (PAC) services, China grapples with a high rate of unintended pregnancies and subsequent abortions. We aimed to study the evolving characteristics of women seeking abortion and their contraceptive practices before and after abortions, to shed light on the optimisation of Chinese PAC services. METHODS: This study utilised data from an abortion cohort between 2019 and 2021. We studied their demographic features, contraception and abortion histories, reasons and choices using chi-square or linear-by-linear tests. We also explored the potential impact of receiving services at PAC facilities on post-abortion contraception use and repeat abortions using logistic regression models. RESULTS: Among the 9005 participants, 43.4% experienced repeat abortion, without a discernible trend over the 3 years. Noteworthy increases were observed in the percentages of college students (from 1.7% to 6.6%, p<0.01) and middle-aged women (from 23.2% to 26.8%, p<0.01) seeking abortions. Surgical abortion was chosen by nearly 90% of participants with a continuously increasing trend (p trend <0.01). Nearly half of the participants experienced unintended pregnancies due to non-use of contraception. Of the remainder, the majority preferred less or the least effective methods both before and after abortion. Women residing in moderate-gross domestic product (GDP) regions faced a higher risk of repeat abortions (OR 1.33, 95% CI 1.16 to 1.54). Despite this, high-quality PAC services may encourage the use of reliable contraceptive methods, with 86.8% of women changing from least effective or no methods to (most) effective methods post-abortion, and prevent repeat abortions (OR 0.65, 95% CI 0.56 to 0.75). CONCLUSIONS: Increased proportions of college students and middle-aged multiparous women seeking abortions were observed, together with inappropriate preferences for less effective contraception and increasing choice of surgical abortions. Future research should extend the focus to cover the entire abortion period, advocate the rational selection of contraceptive methods, and emphasise the specified PAC services tailored to different socioeconomic groups.

Repeat Induced Abortion among Chinese Women Seeking Abortion: Two Cross Sectional Studies.

BACKGROUND: In China, there were about 9.76 million induced abortions in 2019, 50% of which were repeat abortions. Understanding the tendency of repeat induced abortion and identifying its related factors is needed to develop prevention strategies. METHODS: Two hospital-based cross-sectional surveys were conducted from 2005-2007 and 2013-2016 in 24 and 90 hospitals, respectively. The survey included women who sought an induced abortion within 12 weeks of pregnancy. The proportion of repeat induced abortions by adjusting the covariates through propensity score matching was compared between the two surveys, and the zero-inflated negative binomial regression model was established to identify independent factors of repeat induced abortion. RESULTS: Adjusting the age, occupation, education, marital status and number of children, the proportion of repeat induced abortions in the second survey was found to be low (60.28% vs. 11.11%), however the unadjusted proportion was high in the second survey (44.97% vs. 51.54%). The risk of repeat induced abortion was higher among married women and women with children [ORadj and 95% CI: 0.31 (0.20, 0.49) and 0.08 (0.05, 0.13)]; the risk among service industry staff was higher when compared with unemployed women [ORadj and 95% CI: 0.19 (0.07, 0.54)]; women with a lower education level were at a higher risk of a repeat induced abortion (ORadj < 1). Compared with women under the age of 20, women in other higher age groups had a higher frequency of repeat induced abortions (IRadj: 1.78, 2.55, 3.27, 4.01, and 3.93, separately); the frequency of women with lower education levels was higher than those with a university or higher education level (IRadj > 1); the repeat induced abortion frequency of married women was 0.93 (0.90, 0.98) when compared to the frequency of unmarried women, while the frequency of women with children was 1.17 (1.10, 1.25) of childless women; the induced abortion frequency of working women was about 60-95% with that of unemployed women. CONCLUSIONS: The repeat induced abortion proportion was lower than 10 years ago. Induced abortion seekers who were married, aged 20 to 30 years and with a lower education level were more likely to repeat induced abortions.

Repeat induced abortion in 30 Chinese provinces: A cross-sectional study.

OBJECTIVE: To report the proportion and determinants of repeat induced abortions in China. METHODS: Cross-sectional data were collected of 79 954 women who received an induced abortion from 297 hospitals across 30 Chinese provinces in 2013, using a stratified cluster sampling design. Logistic and Poisson regression models were fitted to identify characteristics associated with repeat abortion. Putative factors included age, household registration (hukou) status, marital status, education, occupation, reproductive history, and current contraceptive practices. RESULTS: Of all abortions, 65.2% were repeat induced abortions. The proportion of repeat abortions varied substantially across provinces, from 36.9% in Qinghai to 85% in Hubei. The strongest factors associated with repeat induced abortion were being older than 40 years (adjusted odds ratio [ORadj ] 7.0, 95% confidence interval [CI] 6.2-7.9), divorced or widowed (ORadj 2.1, 95% CI 1.6-2.7), and using oral contraceptives (ORadj 2.1, 95% CI 1.9-2.3). CONCLUSION: A high proportion of repeat induced abortion was observed across many Chinese provinces, highlighting the need to reduce the incidence of unwanted pregnancy. Several sociodemographic and clinical factors were found to be significantly associated with repeat abortions and should be considered in post-abortion family planning services.

In vitro and in vivo studies on magnesium alloys to evaluate the feasibility of their use in obstetrics and gynecology.

Magnesium and its alloys were widely investigated in many body fluid microenvironments including bone, blood, bile, saliva, and urine; however, no study has been conducted in the intrauterine microenvironment. In this study, the degradation behaviors of HP-Mg, Mg-1Ca, and Mg-2Zn alloys in simulated uterine fluid (SUF) were systematically investigated, and then the biological response of four kinds of uterine cells to these materials was observed. For this purpose, the gluteal muscle of rat was used as the implantation position to study the in vivo biocompatibility as a mimic of the intrauterine device (IUD) fixation part. The 120-day immersion test indicated that the Mg-1Ca alloy had a faster degradation rate than the Mg-2Zn alloy and HP-Mg and dissolved entirely in the SUF. Indirect cytotoxicity assay showed that the extracts of HP-Mg, Mg-1Ca, and Mg-2Zn alloys have positive effects on human uterine smooth muscle cells (HUSMC), human endometrial epithelial cells (HEEC), and human endometrial stromal cells (HESC), especially for the Mg-1Ca alloy group. Furthermore, the in vivo experiment showed that HP-Mg, Mg-1Ca, and Mg-2Zn alloy implants cause a light inflammatory response in the initial 3 days, but they were surrounded mainly by connective tissue, and lymphocytes were rarely observed at 4 weeks. Based on the above facts, we believed that it is feasible for using biomedical Mg alloys in obstetrics and gynecology and proposed three kinds of medical device candidates for future R&D. Statement of Significance Magnesium alloys were widely investigated in various body microenvironments including bone, blood, bile, saliva, and urine; however, no study has been conducted in the intrauterine environment. In this work, the degradation behaviors of Mg alloys in simulated uterine fluid were systematically investigated, and then the biological response of four kinds of uterine cells to these materials was observed. For this purpose, the tibialis anterior of a rat model was used as the implantation position to study the in vivo biocompatibility. The comprehensive in vitro and in vivo testing results indicated that biomedical Mg alloys are feasible for use in obstetrics and gynecology. Further, three kinds of medical device candidates were proposed.

Is Repeat Abortion a Public Health Problem among Chinese Adolescents? A Cross-Sectional Survey in 30 Provinces.

The Chinese Family Planning (FP) programme mainly focuses on married couples, and young unmarried women have limited access. This cross-sectional study aims to identify risk factors related to repeat abortions in Chinese adolescents receiving abortions. Data were collected using a questionnaire for all women seeking abortions within 12 weeks of pregnancy during a period of 2 months in 297 participating hospitals randomly selected across 30 provinces of China in 2013. Only the adolescents (younger than the minimum legal married age of 20 years) were included in this study. Of the 2370 adolescents who were receiving abortions, 927 (39%) were undergoing repeat abortions. The primary reason for the current unintended pregnancies was non-use of contraception (68%). Adolescents receiving abortions who had an increased risk of repeat abortions were those who had children (OR 2.57, 95% CI 1.80⁻3.67), those who resided in a middle-developed region (OR 1.81, 95% CI 1.30⁻2.50), those who resided in a relatively poor region (OR 2.40, 95% CI 1.78⁻3.23), and those who had used contraception during the 6 months preceding the survey (OR 1.38, 95% CI 1.12⁻1.71 for condom use). The occupation as a student was a protective factor for adolescents (OR 0.64, 95% CI 0.50⁻0.83). Adolescents should be offered equal access to FP to that of married women in China to reduce unintended pregnancies and repeat abortions. Correct and consistent contraception practice should be promoted.

A qualitative exploration of perceptions and experiences of contraceptive use, abortion and post-abortion family planning services (PAFP) in three provinces in China.

BACKGROUND: The INPAC project aims to evaluate the effectiveness of integrated post-abortion family planning (PAFP) services into existing hospital based abortion services in China. A qualitative study was conducted in three provinces to contribute to developing effective PAFP services through understanding influences on contraceptive use, experiences of abortion and existing PAFP, and their effect on future contraceptive practices from the perspective of users, in the context of social and institutional change. METHODS: Twenty-nine in-depth interviews (IDIs) were undertaken with women who had experienced abortion between 1 and 6 months prior to interview, recruited from three urban and two rural facilities in each province. Thirteen IDIs were also conducted with male partners. Six focus group discussions (FGDs) were carried out with community members from different social groups, including unmarried and married women and men, urban residents and rural-to-urban migrants. RESULTS: Social networks and norms are important in shaping attitudes and behaviour towards abortion and contraception. Widespread concerns were expressed about side-effects, reliability and effects on future fertility of some modern contraceptives. The combination of limited information and choices and a lack of person-centred counselling in PAFP with anxieties about side effects underlies the widespread use of unreliable methods. Gendered power relations significantly influence contraceptive (non)use, with several examples illustrating women's relative lack of power to decide on a method, particularly in the case of condoms. Although the availability of contraceptive information from respected providers can offer impetus for individual behaviour change, social distance from providers reduces opportunities for clients to discuss their difficulties regarding contraceptive use; particularly, but not exclusively for young, unmarried clients. CONCLUSIONS: Increased access to non-commercial, reliable information on contraceptive methods is needed. PAFP services must go beyond simple information provision to ensure that providers take a more person-centred approach, which considers the most appropriate method for individual clients and probes for the underlying influences on contraceptive (non)use. More sensitive reflection on gender norms and relationships is required during counselling and, where women choose this, efforts should be made to include their male partners. Specific attention to provider positionality and skills for counselling young, unmarried clients is needed.

Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China.

Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.

Post-abortion family planning counselling practice among abortion service providers in China: a nationwide cross-sectional study.

OBJECTIVE: To assess the practice of post-abortion family planning (PAFP) counselling among Chinese abortion service providers, and identify the influencing factors. METHODS: A cross-sectional questionnaire survey was conducted between July and September 2013 among abortion services providers in 30 provinces in China. Univariate and multivariable logistic regression analyses were used to identify the factors that influenced PAFP counselling. RESULTS: 94% of the 579 service providers responded to the questionnaire in the survey. The median age was 39 years (range 20-72), and 95% were females. 92% providers showed a positive attitude and had promoted the PAFP counselling services; however, only 57% spent more than 10 min for it. The overall knowledge on PAFP was limited to the participants. After adjusting for potential confounding factors: providers from the middle region (compared with 'east region', ORadj = 3.33, 95% CI: 2.12-5.21) conducted more PAFP counseling; providers with more knowledge (ORadj = 2.08, 95% CI: 1.38-3.15) provided more counseling; and compared with 'middle school and below', providers with higher education gave more counseling [ORadj(95% CI)] for 'college', 'university' and 'master/doctor' [1.99 (1.01,3.92), 2.32 (1.22,4.40) and 2.34 (1.06,5.17), respectively]. CONCLUSIONS: The majority of providers could provide PAFP counselling to women undergone an abortion, but some of them had insufficient time to make it available. Education, knowledge about fertility and reproductive health and residence region were the main factors influencing the practice. Training of health providers and integrating family planning as a part of abortion services are essential to provide adequate PAFP to abortion seekers, thereby reducing the risk of unintended pregnancy.

[Cognition and attitude of postpartum contraception among obstetricians in Tianjin area].

OBJECTIVE: Through analysed the questionnaire about postpartum contraception knowledge-attitude-practice (KAP) among obstetricians, to understand the postpartum contraceptive knowledge, idea, attitude and related factors among obstetricians. METHODS: From October 2013 to December 2013, 209 obstetricians of 10 different levels of the hospital of Tianjin area had been enrolled in this study, and KAP questionnaire was investigated. RESULTS: The knowledge of postpartum contraception among obstetricians was seriously lack, the total correct rate was 34.8%, the lowest score was 5 points, the highest was 80 points, the average score was 34.8±13.5, more than 60 points accounted for only 2.9% (6/209). 86.6% (181/209) obstetricians have thought it necessary to carry out postpartum contraceptive propaganda during pregnancy, and 97.6% (204/209) obstetricians have thought it necessary to develop postpartum contraception training. 92.8% (194/209) and 94.2% (197/209) obstetricians always informed that pay attention to contraception before discharge and postpartum visit, specific methods were not discussed. Obstetricians obtained relevant progress of contraceptive knowledge mainly through the daily medical work (92.8% , 194/209), hoped that approach postpartum contraception related knowlege through continuing education courses (77.5%, 162/209), special lectures in academic conference (72.2%, 151/209) and special training (67.5%, 141/209). CONCLUSIONS: (1) The postpartum contraception knowledge among obstetricians is seriously lack. (2) The obstetricians hold positive attitude towards the propaganda for postpartum contraceptive knowledge. (3) Postpartum contraception related education only provided before discharging and postpartum visit, and the content was simply inform that pay attention to contraception, specific methods are not discussed. (4) To explore the reason why postpartum contraception situation is not ideal, that's because insufficient attention and propaganda, obstetricians don't update the contraception knowledge, and be lack of knowledge on the efficient, long-acting reversible contraception methods, exaggerated the side effects and complications.

A multicenter comparative study of UCu200, TCu380A, and medicated γ-IUD devices inserted immediately after vacuum aspiration.

OBJECTIVE: To compare safety and efficacy among 3 types of intrauterine device (IUD), namely UCu200, TCu380A, and medicated γ-IUD, when inserted after vacuum aspiration. METHODS: In a multicenter randomized comparative study, 1800 parous women requesting an IUD were enrolled in 12 centers across China in 2004-2005. The women received 1 of the 3 types of IUD and were followed-up for 12 months. RESULTS: Among the participants, 596 received the UCu200, 591 received the TCu380A, and 594 received the medicated γ-IUD. No pregnancy occurred during the follow-up period. The expulsion rate was 4.13 per 100 women (95% confidence interval [CI], 0.83-5.75) for the UCu200, 5.16 (95% CI, 0.92-6.96) for the TCu380A, and 2.73 (95% CI, 0.67-4.05) for the medicated γ-IUD. The rate of medical removal of the UCu200, TCu380A, and medicated γ-IUD was 3.60 (95% CI, 0.77-5.11), 2.25 (95% CI, 0.62-3.46), and 1.02 (95% CI, 0.41-1.83), respectively. CONCLUSION: Immediate insertion of the device after vacuum aspiration was found to be safe and effective for all 3 types of IUD. Compared with the other IUDs, the medicated γ-IUD had a lower rate of medical removal and might be the most appropriate for broad use. www.chictr.org: ChiCTR-TRC-12002395.

[Comparison of ultrasound plus radiography versus computed tomography in the diagnosis of ectopic intrauterine devices].

OBJECTIVE: To compare the effectiveness of ultrasound plus radiography versus computed tomography (CT) in the diagnosis of ectopic intrauterine device (IUD) and analyze the ratio of cost and effectiveness (C/E) so as to provide scientific rationales for the selection of appropriate diagnostic methods. METHODS: A total of 70 cases were recruited from two major Chinese hospitals in 2009. They were examined with ultrasound plus radiography and CT respectively. The gold diagnostic criterion was postoperative diagnosis to compare the sensitivity, specificity, diagnostic index (DI), accuracy and C/E for different diagnostic methods. The SPSS 13.0 statistical analysis software was employed for data analysis. RESULTS: The data of 65 subjects were collected and analyzed. For ultrasound plus radiography, the sensitivity, specificity, DI, accuracy and C/E were 82.1%, 88.9%, 171.0%, 83.1% and 137.3 respectively. As for CT, the above indices were 96.4%, 55.6%, 152.0%, 90.8% and 170.7 respectively. CONCLUSION: Considering the higher levels of specificity and DI and a lower C/E, ultrasound plus radiography is superior to CT so that the former modality shall become a first-choice in the diagnosis of ectopic IUD, especially at the grass-root family planning service stations.

[The comparison of efficacy of female sterilization by modified Uchida technique and silver clips in China].

OBJECTIVE: To compare efficacy of female sterilization by modified Uchida technique and silver clips and to evaluate the influence on operation procedure and clinical effect with or without surgery training of service providers. METHODS: A comparative, multicenter clinical trial was performed in 18 county and township-level service centers. Totally 2198 women underwent sterilization from these 18 study center were divided into 1116 women sterilized by modified Uchida technique and 1082 women by silver clips. Those 18 centers were classified into 9 training groups which provide surgical skills of sterilization and other contents and 9 non training groups. Clinical documents of sterilization were recorded. All women were follow-up at 3, 6 and 12 months after surgery. RESULTS: There were no complications during surgery by both sterilization. The failure rate was 2.03% (22/1082) in silver clip method and the mean operative time were (12.4 ± 6.4) minutes in training group and (14.4 ± 8.1) minutes in non training group. In modified Uchida method, the failure rate was 0.18% (2/1116) and the mean operative time were (16.2 ± 4.9) minutes in training group and (19.0 ± 8.6) minutes in non training group. The mean operative time between two groups reached statistical difference (all P < 0.05). Total ended rate in modified Uchida technique were 2.2/hundred women year in training group and 2.5/hundred women year in non training group, and the rate of silver slips were 3.9/hundred women year and 4.8/hundred women year, which did not show significant difference (all P > 0.05). There was no significant difference in acceptability and side effects of all women between two methods (P > 0.05). The training of service providers could influence acceptability of women (P < 0.05). CONCLUSIONS: Clinical efficacy was not influenced by those two methods. The operative time and acceptability were improved by training surgeons in silver clips method.

A comparative study of female sterilization via modified Uchida and silver clip techniques in rural China.

OBJECTIVE: To compare the specific effects of 2 female sterilization methods: the modified Uchida technique and the application of silver clips. METHODS: A total of 2198 women living in rural areas who were still of reproductive age but opting for sterilization were enrolled. The participants were randomly divided into 2 groups, and underwent sterilization by either modified Uchida technique or silver clips. Information on acceptability, operation conditions, effectiveness, adverse effects, and complaints was collected 3, 6, and 12 months after the procedure. RESULTS: No significant difference in effectiveness, adverse effects or chief complaints between the 2 procedures was found. Differences in operative outcome, bleeding volume during the procedure, and operation time were found. CONCLUSION: A shorter operation time and less bleeding for the silver clip method indicated that female sterilization by this technique was as safe as that by modified Uchida technique.

Family planning technical services in China.

Family planning is a basic state policy in China. Its aim is to control population growth and to enhance population quality. Technical services are the key measures for implementing the family planning policy. In order to ensure that people use safe, effective, and appropriate contraceptive methods based on the government's commitment, China has established countrywide family planning service networks down to the township level. The people can access various and convenient contraceptive services. In urban areas, all contraceptive services are free. The contraceptive prevalence rate in 2007 was 84.6%, the percentage of intrauterine device (IUD) was 52.3%, that of female sterilization was 32.3%, and that of vasectomy was 6.1%. This means that more than 90% of married childbearing couples were using long-term contraceptives. At the same time, the government gives priority to supporting research on contraceptive technology. Studies' results have provided scientific evidence for development, introduction, and expansion of contraceptive methods, and also for establishment and revision of the technical guidelines. Great efforts have been made in promoting "human-oriented and client-centered" services during the recent ten years. Remarkable success has been achieved in improving the quality of technical services.

[Induced abortion in China: problems and interventions].

Pooled literatures showed that the induced abortion in China faces many problems:the number of induced abortion remains large; most cases are young and nulliparity women; the frequency of abortion is high; and the interval between one and another abortion is short. Health promotion strategies should be applied to address these problems. It is important to increase the population's awareness of contraception,especially among nulliparity and migrant populations. Routine and effective contraceptive methods should be recommended and emphasized during induced abortion and delivery to lower the rate of induced abortion.

[Design of an implantable sensor for detecting uterine musculature deformation and analysis of its performance].

In gynecology, it is very important to obtain the parameters of women's uterine musculature, such as its deformation size and contraction frequency, etc. This paper proposes a type of sensor for measuring these parameters and also analyzes its force situation. The sensor is flexible, deformable, and can adjust itself to the shape of the uterus. It can be put into the women's uterine cavity easily. The experiment shows that the sensitivity of the left and right sets coils of the sample sensor achieves 22.38 nH/mm2, while that of the top set coils achieves 22.84 nH/mm2, and the reaction time of the sensor is less than 200 ms. These results can meet the requirements of sensitivity and reaction time for testing the contraction situation of uterine musculature. The sensor has been applied in some medical fields.

Gestrinone compared with mifepristone for emergency contraception: a randomized controlled trial.

OBJECTIVE: To compare the efficacy of gestrinone with that of mifepristone for emergency contraception. METHODS: A randomized double-blind trial was conducted in five family-planning clinics in China. We randomly assigned 998 healthy women with regular menstrual cycles and negative urine pregnancy tests who were requesting emergency contraception up to 72 hours after unprotected coitus to receive single-dose 10 mg gestrinone (n=499) or 10 mg mifepristone (n=499). We monitored them to 7 days after the expected first day of their next menstrual period. The study was powered to detect a 5% failure rate between the two regimens. RESULTS: The treatment groups did not differ significantly; posttreatment pregnancy rates were 2.4% in the gestrinone group compared with 1.8% in the mifepristone group (P=.51). The majority of women menstruated the first day of expected menses, and groups did not differ regarding side effects. CONCLUSION: The effectiveness of 10 mg gestrinone is not significantly different from 10 mg mifepristone as an emergency contraceptive method. CLINICAL TRIAL REGISTRATION: ISRCTN Register, isrctn.org, ISRCTN87842530. LEVEL OF EVIDENCE: I.

[Efficacy of intrauterine device TCu380A when inserted in four different periods].

OBJECTIVE: To compare the effectiveness of TCu380A intrauterine device (IUD) inserted in menstrual interval, immediately after vacuum aspiration, and early and later lactation periods. METHODS: A comparative, multicentre clinical trial was performed. Totally 2293 eligible women were inserted TCu380A IUD during the above mentioned 4 different period. RESULTS: Among 2293 women, 852 cases inserted in menstrual interval, 591 cases of them immediately inserted after vacuum aspiration, and 451 cases and 399 cases of them inserted at early and later lactation periods. By the end of 1st year, no uterine perforation and pelvic inflammatory disease were found. The pregnancy rates with IUD in situ from the four groups were low (< or = 0.51/hundred women year). The rate of removal for displacement in the group of later lactation period was the highest (8.08/hundred women year), while the lowest (3.97/hundred women year) in the group of immediately after vacuum aspiration. There were significant difference among the four groups (P < 0.05). The lowest rates of the total or partial expulsion were in the later lactation group, which were 0.25 and 0.26/hundred women year. The medical removal rate for bleeding and (or) pain in the four groups were 1.94, 1.73, 1.42 and 1.33/hundred women year, and there were no significantly difference among the four groups (P > 0.05). CONCLUSION: Insertion of TCu380A IUD in the above mentioned four periods are feasible, safe and effectiveness.

[An epidemiological survey on intrauterine device downward dislocation in Chinese rural users].

OBJECTIVE: To understand the situation of downward dislocation of intrauterine device (IUD) and the impact related to the effectiveness of HJD use, in China. METHODS: An epidemiological survey with cross-sectional, retrospective and prospective study designs was conducted to investigate 18,922 IUD users who were selected by a multi-phase stratified cluster sampling method. RESULTS: IUD's downward dislocation had been an important unsuccessful issue related to the IUD insertion that accounted for 20% of total the cases of failure. The top three failure outcomes would include extrusion, removal due to downward dislocation and unintended pregnancy. Respectively, the cumulative rates and the ranking due to IUD failure (per 100 women) in the first, third, sixth and twelfth month were shown as follows: extrusion appeared as 0.33%, 1.13%, 2.21% and 4.30%; removal as 0.10%, 0.37%, 0.80% and 2.34%; while unintended pregnancy were 0.03%, 0.14%, 0.41% and 1.14%. CONCLUSION: IUD's downward dislocation made great impact on the effectiveness of IUD use that should call for attention from relative governmental sectors and researchers in the areas of prevention, diagnosis and treatment.

Design and application of a flexible and implantable sensor for detecting uterine musculature contraction.

It is very important to obtain the parameters of deformation size and contraction frequency of women's uterine musculature in medical research. This paper proposes a type of sensor for measuring these parameters and analyzes its force situation. The flexibility of the sensor makes it easy for doctors to let the sensor pass through woman's narrow cervix and get to her uterine cavity. The experiment shows that the sensitivity of three coils in the sample sensor achieves 22.38 nH/mm(2) both for left and right coils, 22.84 nH/mm(2) for top coil, which can meet the requirements of sensitivity for testing the contraction situation of uterine musculature. Furthermore, an interface designed in the back end system can display the parameters of deformation size and vivid contraction situation of women's uterine musculature in real-time. The sensor has been applied in some medical fields.