Objective To assess the effectiveness, side effects, and acceptability of copper uterine cavity - shaped intrauterine devices （UCD） with and without indomethacin. Methods We used electronic search and hand search to...Objective To assess the effectiveness, side effects, and acceptability of copper uterine cavity - shaped intrauterine devices （UCD） with and without indomethacin. Methods We used electronic search and hand search to identify relevant literatures. Included papers were systematically reviewed according to previous established guidelines. Results A total of 39 related papers were identified. Of them, 9papers were included in this review： 4 associated with medicated or non-medicated UCD200 （containing copper 200 mm^2） and 5 associated with medicated or non-medicated UCD300 （containing copper 300 mm^2）. The contraceptive effectiveness, cumulative one-year and two-year continuation rates＇ were similar between medicated UCD200, non-medicated UCD200 and TCu220C. The effectiveness of non-medicated UCD300 was similar to that of TCu220C and TCu200. The effectiveness of medicated UCD300 was similar to that of MLCu375 and TCu220C but lower than that of TCu38OA. The cumulative one-year, three-year and five-year continuation rates were similar between medicated, non-medicated UCD300 and TCu380A or MLCu375. The problem of bleeding was less common among medicated UCD users than among non-medicated devices. Conclusions Uterine cavity-shaped devices should continue to be used in the National Family Planning Proramme. However, priority should be given to the 300 mm^2 copper containing device. A large multicenter randomized comparative trial of UCD300 and TCu380A is needed.展开更多
Background Contraceptive use after childbirth can reduce risk of unplanned pregnancy.This study estimated the prevalence of contraception use in the 1 year after childbirth.It further examined factors associated with ...Background Contraceptive use after childbirth can reduce risk of unplanned pregnancy.This study estimated the prevalence of contraception use in the 1 year after childbirth.It further examined factors associated with use of the most and moderately effective forms of reversible contraception in the 1-year period after childbirth.Methods This cross-sectional study used Phase 8data from the Pregnancy Risk Assessment Monitoring System(PRAMS)(2016–2020)in the USA(N=194032).Prevalence,overall and by type,was estimated nationally,by state and by age.Multinomial logistic regression models estimated associations with the most and moderately effective forms of reversible contraception(vs non-use).The most effective reversible contraception consisted of long-acting reversible contraception(LARC);moderately effective reversible contraception was a combined category of the injection,pill,patch,vaginal ring and diaphragm.Results Moderately effective reversible contraception was the most common method used(24.8%)followed by no contraception(23.9%)and then use of the most effective reversible contraception(17.0%).Variation by age and state in LARC use was demonstrated.Having had a postpartum visit was the factor most strongly associated with LARC use in the 1 year after childbirth(adjusted OR(aOR):4.96,95%CI:4.91 to 5.01).In contrast,being married at the time of the survey was the factor most strongly associated with use of moderately effective reversible contraception(a OR:1.55,95%CI:1.54 to 1.56).Conclusion Higher prevalence of no contraception or less effective forms of birth control presents an opportunity for greater LARC adoption,if preferred,especially at the postpartum visit.展开更多
文摘Objective To assess the effectiveness, side effects, and acceptability of copper uterine cavity - shaped intrauterine devices （UCD） with and without indomethacin. Methods We used electronic search and hand search to identify relevant literatures. Included papers were systematically reviewed according to previous established guidelines. Results A total of 39 related papers were identified. Of them, 9papers were included in this review： 4 associated with medicated or non-medicated UCD200 （containing copper 200 mm^2） and 5 associated with medicated or non-medicated UCD300 （containing copper 300 mm^2）. The contraceptive effectiveness, cumulative one-year and two-year continuation rates＇ were similar between medicated UCD200, non-medicated UCD200 and TCu220C. The effectiveness of non-medicated UCD300 was similar to that of TCu220C and TCu200. The effectiveness of medicated UCD300 was similar to that of MLCu375 and TCu220C but lower than that of TCu38OA. The cumulative one-year, three-year and five-year continuation rates were similar between medicated, non-medicated UCD300 and TCu380A or MLCu375. The problem of bleeding was less common among medicated UCD users than among non-medicated devices. Conclusions Uterine cavity-shaped devices should continue to be used in the National Family Planning Proramme. However, priority should be given to the 300 mm^2 copper containing device. A large multicenter randomized comparative trial of UCD300 and TCu380A is needed.
文摘Background Contraceptive use after childbirth can reduce risk of unplanned pregnancy.This study estimated the prevalence of contraception use in the 1 year after childbirth.It further examined factors associated with use of the most and moderately effective forms of reversible contraception in the 1-year period after childbirth.Methods This cross-sectional study used Phase 8data from the Pregnancy Risk Assessment Monitoring System(PRAMS)(2016–2020)in the USA(N=194032).Prevalence,overall and by type,was estimated nationally,by state and by age.Multinomial logistic regression models estimated associations with the most and moderately effective forms of reversible contraception(vs non-use).The most effective reversible contraception consisted of long-acting reversible contraception(LARC);moderately effective reversible contraception was a combined category of the injection,pill,patch,vaginal ring and diaphragm.Results Moderately effective reversible contraception was the most common method used(24.8%)followed by no contraception(23.9%)and then use of the most effective reversible contraception(17.0%).Variation by age and state in LARC use was demonstrated.Having had a postpartum visit was the factor most strongly associated with LARC use in the 1 year after childbirth(adjusted OR(aOR):4.96,95%CI:4.91 to 5.01).In contrast,being married at the time of the survey was the factor most strongly associated with use of moderately effective reversible contraception(a OR:1.55,95%CI:1.54 to 1.56).Conclusion Higher prevalence of no contraception or less effective forms of birth control presents an opportunity for greater LARC adoption,if preferred,especially at the postpartum visit.
