A non-comparative study of the Norplant contraceptive subdermal implant system was conducted in Dhaka, Bangladesh. The study was designed to evaluate the contraceptive efficacy, safety and overall acceptability of Norplant implants. Six hundred women were enrolled in the clinical trial, which began in 1985 at three study sites. Follow-up visits were scheduled at 1, 3, and 6 months after Norplant implant insertion, and every six months thereafter until removal or at the end of five years. There were no post-insertion pregnancies during Norplant implant use in this study. After five years of Norplant implant use, there was no clinically significant change in body weight, systolic or diastolic blood pressure. Less than 3% of the women ever reported having any significant medical problems such as migraine, respiratory or cardiac problems during the study. The gross cumulative continuation rate was 41.2 per 100 women at the end of five years. The two most frequently reported reasons for discontinuation during the study were menstrual problems and desired pregnancy. Of the women who completed the five-year user satisfaction questionnaire, the majority of the women (86.3%) planned to continue using contraception after study completion. Of these women, approximately one-third said they planned to use another Norplant set. The findings presented suggest that the Norplant system is a highly effective, safe and acceptable method among Bangladeshi women.

From February 1985 to February 1986, researchers enrolled 600 18-40 year old women at the Dhaka Medical College and Hospital, the Institute of Postgraduate Medicine and Research, and the Mohammadpur Fertility Services and Training Centre in a 5-year clinical trial to evaluate the contraceptive efficacy, safety, and acceptability of Norplant subdermal implants in Bangladesh. They scheduled the women to return for follow-up visits 1, 3, and 6 months after insertion and every 6 months thereafter until removal or at the end of 5 years. No pregnancies after insertion occurred during the study. The gross cumulative continuation rate was 93.9% at 1 year and 72.3% at 2 years. The 5-year cumulative continuation rate was 41.2% which was much lower than that in other Asian countries (e.g., 52.3% in Sri Lanka and 78.2% in Indonesia). The 5-year cumulative discontinuation rate for menstrual problems was 30.7% which was higher than that of other studies. It may have been higher because Bangladeshi women do not tolerate well and accept changes in bleeding patterns, especially since menstrual bleeding prevents them from prayer and taking part in sexual activity. 45.3% of all women requesting early Norplant removal complained of menstrual problems, especially prolonged heavy bleeding (75% of women requesting removal for menstrual problems). Most menstrual problem removals took place during the 2nd year and fell thereafter. Desired pregnancy was the second most common reason for removal (18.6%). The gross discontinuation rate for nonmenstrual side effects was just 2.2%, the main side effect being headaches. 97.5% of women who completed the 5-year study considered their experience with Norplant favorable. The leading reason for a favorable rating for Norplant was its duration of use (64.5%). Menstrual changes comprised the least favorable component of Norplant among women who completed the study (63.3%). 33% of women still wanting to use contraception after 5 years of Norplant use said they would use Norplant again.

译文

在孟加拉国达卡进行了Norplant避孕皮下植入系统的非比较研究。该研究旨在评估Norplant植入物的避孕功效,安全性和总体可接受性。600名妇女参加了临床试验,该试验在三个研究地点开始1985年。计划在插入Norplant植入物后的1、3和6个月进行随访,此后每六个月进行一次随访,直到移除或五年结束。在这项研究中,在使用Norplant植入物期间没有插入后怀孕。使用Norplant植入物五年后,体重,收缩压或舒张压无临床显着变化。在研究期间,只有不到3% 的女性报告有任何重大的医学问题,例如偏头痛,呼吸系统或心脏问题。在五年结束时,总累积延续率为每100名妇女41.2。研究期间停药的两个最常报告的原因是月经问题和预期怀孕。在完成五年用户满意度问卷的妇女中,大多数妇女 (86.3%) 计划在研究完成后继续使用避孕措施。在这些妇女中,大约3分之1人说他们计划使用另一套Norplant。提出的研究结果表明,Norplant系统是孟加拉国妇女中非常有效,安全和可接受的方法。
从1985年2月到1986年2月,研究人员在达卡医学院和医院,研究生医学和研究所招募了600名18-40岁的妇女,和Mohammadpur生育服务和培训中心进行了为期5年的临床试验,以评估孟加拉国Norplant皮下植入物的避孕功效,安全性和可接受性。他们安排这些妇女在插入后1、3和6个月返回进行随访,此后每6个月返回一次,直到取出或5年结束。在研究期间,插入后没有怀孕。总累积延续率在1年时93.9%,在2年时72.3%。5年累积延续率41.2%,远低于其他亚洲国家 (例如,斯里兰卡的52.3% 和印度尼西亚的78.2%)。月经问题的5年累积停药率为30.7%,高于其他研究。它可能更高,因为孟加拉国妇女不能很好地忍受和接受出血模式的变化,特别是因为月经出血阻止她们祈祷和参与性活动。所有要求早期去除Norplant的妇女的45.3% 抱怨月经问题,特别是长期大量出血 (75% 要求去除月经问题的妇女)。大多数月经问题清除发生在第二年,此后下降。期望怀孕是第二个最常见的切除原因 (18.6%)。非月经副作用的总停药率仅为2.2%,主要副作用是头痛。完成5年研究的女性97.5% 认为她们在Norplant的经历是有利的。Norplant获得良好评级的主要原因是其使用期限 (64.5%)。在完成研究的女性中,月经变化是Norplant最不利的成分 (63.3%)。使用Norplant 5年后仍想使用避孕药的妇女中有33% 表示将再次使用Norplant。

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