New developments in intrauterine device use: focus on the US.
New developments in intrauterine device use: focus on the US.
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DOI：
10.2147/oajc.s85755
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发表时间：
2016
影响因子：
2.1
通讯作者：
Massoudi N
中科院分区：
文献类型：
--
作者：
Nelson AL;Massoudi N
与过去相比，今天美国有更多的女性依赖宫内节育器(IUD)。这种使用率的增加可能在很大程度上导致了美国意外怀孕百分比的下降。循证做法增加了医学上有资格使用宫内节育器的妇女人数，并使人们能够更快地获得这种方法。许多妇女享有免费使用宫内节育器的自由，但对许多人来说，《平价医疗法案》的影响尚未实现。目前，美国有三种激素性宫内节育器和一种铜质宫内节育器。每一个宫内节育器都非常有效、方便和安全。较新的宫内节育器已经在通常不包括在临床试验中的人群中进行了测试，并为这些妇女使用宫内节育器的旧担忧提供了令人放心的答案，包括有关驱逐、感染和停用的信息。另一方面，更大规模的监测研究对穿孔等并发症的风险提供了新的估计，特别是在产后和哺乳妇女中。本文总结了每种宫内节育器的显著特点，并总结了不同之处，以帮助美国和其他国家的临床医生在建议妇女选择宫内节育器时提供帮助。
Many more women in the US today rely upon intrauterine devices (IUDs) than in the past. This increased utilization may have substantially contributed to the decline in the percentage of unintended pregnancies in the US. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Many women enjoy freedom to use IUDs without cost, but for many the impact of the Affordable Care Act has yet to be realized. Currently, there are three hormonal IUDs and one copper IUD available in the US. Each IUD is extremely effective, convenient, and safe. The newer IUDs have been tested in populations not usually included in clinical trials and provide reassuring answers to older concerns about IUD use in these women, including information about expulsion, infection, and discontinuation. On the other hand, larger surveillance studies have provided new estimates about the risks of complications such as perforation, especially in postpartum and breastfeeding women. This article summarizes significant features of each IUD and provides a summary of the differences to aid clinicians in the US and other countries in advising women about IUD choices.