Contraceptive practice after surgical repair of obstetric fistula in southeast Nigeria
Contraceptive practice after surgical repair of obstetric fistula in southeast Nigeria
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DOI：
10.1016/j.ijgo.2014.11.028
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发表时间：
2015-06-01
影响因子：
3.8
通讯作者：
Ezeonu, Paul O.
中科院分区：
文献类型：
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作者：
Lawani, Lucky O.;Iyoke, Chukwuemeka A.;Ezeonu, Paul O.
目的：确定产科瘘修复术后妇女的避孕措施，并评估第一年避孕率和妊娠率的决定因素。方法：一项前瞻性队列研究纳入了 2011 年至 2013 年间在尼日利亚某中心成功进行产科瘘手术修复的女性。患者接受了为期 1 年的随访。数据是通过记录审查和完成半结构化调查问卷获得的。结果：188 名参与者中，180 名（95.7%）有避孕意识，但只有 70 名（37.2%）在手术后使用了避孕方法。最常用的方法是男用避孕套（70 例中有 50 例[71.4%]）和激素注射（14 例[20.0%]）。不使用的主要原因是担心副作用（118 名女性中有 48 名[40.7%]）、未来想要更多孩子的愿望（35 名[29.7%]）、宗教禁止（26 名[22.0%]）、文化信仰（29 名[24.6%]）和伴侣不赞成（42 名[35.6%]）。使用避孕药具的女性第一年意外怀孕的风险显着低于未使用避孕药具的女性（相对风险0.14，95%置信区间0.02-1.06；P = 0.03）。结论：由于社会经济原因、宗教和文化信仰以及神话，瘘管修复手术后避孕措施的采用率较低，导致意外怀孕。 (C) 2015 年国际妇产科联合会。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Objective: To determine the contraceptive practices of women after surgical repair of obstetric fistula and to assess determinants of uptake and the pregnancy rate in the first year. Methods: A prospective cohort study enrolled women who had a successful surgical repair of obstetric fistula at a center in Nigeria between 2011 and 2013. Patients were followed up for 1 year. Data were obtained through record review and completion of a semi-structured questionnaire. Results: Among 188 participants, 180 (95.7%) were aware of contraception, but only 70 (37.2%) used contraceptive methods after surgery. The most commonly used methods were the male condom (50 [71.4%] of 70) and hormonal injections (14 [20.0%]). The main reasons for non-use were fear of adverse effects (48 [40.7%] of 118 women), future desire for more children (35 [29.7%]), religious prohibition (26 [22.0%]), cultural beliefs (29 [24.6%]), and partner disapproval (42[35.6%]). The risk of unplanned pregnancy in the first year was significantly lower among women who used contraceptives than among those who did not (relative risk 0.14,95% confidence interval 0.02-1.06; P = 0.03). Conclusion: Contraceptive uptake for birth control after fistula repair surgery was low because of socioeconomic reasons, religious and cultural beliefs, and myths, resulting in unplanned pregnancies. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.