[1]刘小艳,刘佳,蔡惠芬,等.40岁以上高龄女性意外妊娠人流术后即时高效避孕的临床观察[J].第三军医大学学报,2020,42(23):2350-2356.
 LIU Xiaoyan,LIU Jia,CAI Huifen,et al.Clinical observation of immediately high-efficiency contraception after unintended pregnancy induced abortion in women over 40 years old[J].J Third Mil Med Univ,2020,42(23):2350-2356.
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40岁以上高龄女性意外妊娠人流术后即时高效避孕的临床观察(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第23期
页码:
2350-2356
栏目:
临床医学
出版日期:
2020-12-15

文章信息/Info

Title:
Clinical observation of immediately high-efficiency contraception after unintended pregnancy induced abortion in women over 40 years old
作者:
刘小艳刘佳蔡惠芬郑雅心常青
陆军军医大学(第三军医大学)第一附属医院妇产科
Author(s):
LIU Xiaoyan LIU Jia CAI Huifen ZHENG Yaxin  CHANG Qing
Department of Gynecology and Obstetrics, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
 
关键词:
 高龄女性高效避孕流产后关爱
Keywords:
 
分类号:
R169.41; R181.23; R719.3
文献标志码:
A
摘要:

目的分析40岁以上高龄女性人工流产术后即时高效避孕落实和续用情况,评价规范的流产后关爱(post abortion care,PAC)流程在降低高龄女性意外妊娠发生率中的价值。方法收集本院2019年实施人工流产手术的40岁以上高龄女性临床资料,收集同期实施人工流产手术育龄(20~40岁)女性临床资料。所有病例遵循PAC流程规范服务,术后随访1、3、6个月。比较两组女性日常避孕方法、此次意外妊娠原因和人流术后即时高效避孕落实、高效避孕方法续用和再次意外妊娠情况。结果此次意外妊娠人流术前,高龄组流产次数显著多于育龄组(t=6.986,P<0.001);两组避孕方法的构成比差异有统计学意义(χ2=30.612,P<0.001),避孕套仍是最常用的避孕方法(50.79% vs 72.22%)。此次人流术后,高龄组即时避孕落实率高于育龄组(96.83% vs 90.87%,χ2=4.487,P=0.034),但高效避孕措施落实率差异无统计学意义(χ2=2.550,P=0.110);高龄组术后1、3、6个月随访率高于育龄组(P<0.05),随访至术后3、6个月时,高龄组的高效避孕措施落实率高于育龄组(P<0.05),术后6个月再次意外妊娠发生率低于育龄组(χ2=4.845,P=0.028)。结论40岁以上高龄女性意外妊娠人流术后即时高效避孕落实率、续用情况优于育龄女性,再次意外妊娠发生率较低;规范实施PAC服务,有助于高龄女性人流术后即时落实高效长效避孕措施,提高其续用率,降低意外妊娠和重复人工流产率。

Abstract:

ObjectiveTo explore the implementation and continued use of high-efficiency contraception in over-40-year-old women immediately after induced abortion, and evaluate the value of post-abortion care (PAC) Performance Standards in reducing the rate of unintended pregnancy in senior women. MethodsClinical data of 126 women over 40 years of age who underwent abortion in our hospital in the year of 2019, and of 252 woman at childbearing age (20~40 years old) undergoing abortion during the same period were collected in this study. All cases were given services in accordance with the PAC Performance Standards, and then followed up for 1, 3, and 6 months. The daily contraceptive methods, cause of this unexpected pregnancy, implementation of immediate and efficient contraception after abortion, rate of continued use of high-efficiency contraceptive methods (long- or short-acting contraceptive methods), and incidence of another unexpected pregnancy were analyzed and compared between the 2 groups. Results Before this accidental abortion, the time of abortions was significantly higher in the elderly group than the childbearing age group (t=6.986, P<0.001). Although the 2 groups differed in the composition ratio of the 2 contraceptive methods (Chi-square=30.612, P<0.001), condoms were still the most commonly used method (50.79% vs 72.22%). The implementation rate of immediate and efficient contraception after abortion was obviously higher in the elderly group than the childbearing age group (96.83% vs 90.87%, Chi-square=4.487, P=0.034), but no statistical difference was seen (Chi-square=2.550, P=0.110). The elderly group had higher follow-up rate at 1, 3, and 6 months postoperatively (P<0.05), higher implementation rate of effective contraceptive measures (P<0.05) at the time points of follow-up, and lower incidence of unintended pregnancy at 6 months postoperatively (Chi-square=4.845, P=0.028) when compared with the childbearing age group. ConclusionThe women over 40 years of age have higher rates of implementation and continued use of high-efficiency contraception after accidental pregnancy, and lower re-unexpected pregnancy than the women of childbearing age. PAC Performance Standards are helpful to the senior women receiving effective and long-acting contraceptive measures immediately after abortion, increasing their continued rate, reducing the rates unintended pregnancy and repeated abortion. 

更新日期/Last Update: 2020-12-04