Clinical Assessment of 3 Intrauterine Devices in Adolescent Girls: A Randomized Clinical Trial

被引:2
作者
Anjos, Fabiana C. Q. S. [1 ]
Marcelino, Ana C. [2 ]
Espejo-Arce, Ximena [2 ]
Pereira, Paula da C. [2 ]
Barbosa, Priscila F. [1 ]
Juliato, Cassia T. [2 ]
Bahamondes, Luis [2 ,3 ]
机构
[1] Univ Gurupi, Fac Med Sci, Dept Obstet & Gynecol, Gurupi, TO, Brazil
[2] Univ Estadual Campinas, Fac Med Sci, Dept Obstet & Gynecol, Campinas, SP, Brazil
[3] Caixa Postal 6181, BR-13084971 Campinas, SP, Brazil
基金
巴西圣保罗研究基金会;
关键词
Adolescent; Contraception; Intrauterine devices; Levonorgestrel IUD; Copper; 380; mm; 2; IUD; Expulsion; Continuation rate; BLEEDING PATTERNS; YOUNG-WOMEN; EFFICACY; SAFETY; SYSTEM;
D O I
10.1016/j.jpag.2023.12.002
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Study Objective: To assess clinical performance, bleeding pattern, dysmenorrhea, and satisfaction up to 1 year after placement of 3 types of intrauterine devices (IUDs) (TCu380A, levonorgestrel 52 mg, and levonorgestrel 19.5 mg) in adolescents Methods: The study was a randomized trial with 318 adolescents allocated to the 3 IUDs. We assessed reasons for removal, continuation, menstrual patterns, dysmenorrhea, and satisfaction. Results: Participants aged (mean +/- SD) 17.9 +/- 1.4 years, with 80.8% being nulligravidae. After 1 year, 265 (83.3%) continued using the IUD; however, the continuation rate of TCu380A (75.4 +/- 4.2) was lower than that of both the levonorgestrel 52-mg (88.6 +/- 3.1) and 19.5-mg IUDs (86.8 +/- 3.3), and bleeding/pain and expulsion were the main reasons for removal of the TCu380A IUD. The duration of menstruation was longer among the TCu380A IUD users (6.0 +/- 2.0 days) than those using the levonorgestrel 52 mg (2.5 +/- 3.9) and 19.5 mg (3.2 +/- 3.2) devices, P < .001. Amenorrhea was reported by 49.5% and 37.8% users of the levonorgestrel 52-mg and 19.5-mg devices, respectively, P < .001. Dysmenorrhea was reported in 68.5% of all participants at the baseline; this was 67.9% of the TCu380A group and 33.3% and 36.0% of the levonorgestrel 52-mg and 19.5-mg IUD groups, respectively, P < .001. Satisfaction ranged from 80.7% in the TCu380A group to 97.8% in the levonorgestrel 52-mg group ( P = .03). Conclusion: The 3 IUDs are suitable for adolescents, with high contraceptive efficacies and rates of continuation within 1 year of use and high degrees of satisfaction. Users of the hormonal IUDs reported lower expulsion rates, more favorable menstrual patterns, and less dysmenorrhea compared with the TCu380A IUD.
引用
收藏
页码:165 / 170
页数:6
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