Long-Acting Reversible Contraception
Long-Acting Reversible Contraception
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DOI：
10.1097/aog.0000000000004967
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发表时间：
2022-11-01
影响因子：
7.2
通讯作者：
Creinin, Mitchell D.
中科院分区：
文献类型：
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作者：
Baker, Courtney C.;Creinin, Mitchell D.
长效可逆避孕(LARC)方法是有效的避孕选择。目前在美国可用的产品包括一种依托诺孕酮植入物、一种铜质宫内节育器(IUD)和几种左炔诺孕酮宫内节育器。随着使用率和使用时间的增加，我们对疗效、风险和益处的理解也发生了变化。除了在身体自主和生殖公正的框架内对命名和LARC的使用进行简要讨论外，这篇综述还包括放置和移除的临床挑战、基于证据的使用持续时间以及如何减轻副作用。尽管所有产科-妇科医生以及初级保健临床医生都可以安全地提供LARC，但随着避孕技术的不断发展，复杂的计划生育专家是具有挑战性的病例和循证护理的专家转介来源。
Long-acting reversible contraceptive (LARC) methods are effective options for pregnancy prevention. Currently available products in the United States include an etonogestrel implant, a copper intrauterine device (IUD), and several levonorgestrel IUDs. With increasing prevalence and duration of use, our understanding of efficacy, risks, and benefits has evolved. In addition to a brief discussion on nomenclature and LARC use within a framework of bodily autonomy and reproductive justice, this review covers clinical challenges with placement and removal, evidence-based duration of use, and how to mitigate side effects. Although all obstetrician-gynecologists as well as primary care clinicians can safely provide LARCs, complex family planning specialists are an expert referral source for challenging cases and evidence-based care as contraceptive technology continues to develop.