Post-abortion rehabilitation with low-dose combined oral contraceptives: method of optimization of reproductive health

Post-abortion rehabilitation with low-dose combined oral

contraceptives: method of optimization of reproductive health

V.E. Radzinsky, I.S. Saveljeva, T.S. Cherednichenko,

Kostin, Semjatov

Russian University of People Friendship, Moscow, Russia and

Research Centre of Obstetrics and Gynecology, Moscow, Russia

For the last 5 years in Russia a decrease of an absolute number

of induced abortions has been noted5and the ratio ‘abortion – labor’ has

made up 1.3: 1.0 (in 1998 it was 2 : 1). At the same time the same decrease has

not been registered among the adolescent group, and first pregnancies of

teenagers still result in induced abortions in 80% (‘abortion-labor’ ratio

is 5.0: 1.0). Our findings have demonstrated that induced interruption of first

pregnancies leads to hormonal disorders in endocrine system, and the uterus as a

target organ as well as endometrium endures the same changes because the local

haemostasis is mostly regulated by endocrine system. As a result there occurs a

disturbance of cyclic processes in endometrium, chronic endometritis that in its

turn leads to reproductive function disorders. Out studies have demonstrated

that in case the first pregnancy outcomes with induced abortion the probability

of complications during the following pregnancy increases two-fold: threatened

abortions, gestosis, intrauterine fetal growth retardation, disorders of early

postnatal adaptation of newborns. The objectives of the study were to assess the

possibilities of rehabilitation of reproductive system after induced abortions

in adolescents with combined oral contraceptives (COC).

Materials and Methods: A prospective study has been

carried out which included 183 girls after induced interruption of the first

pregnancy. Low dose COC Regulon and Novynette (Gedeon Richter, Hungary) have

been used for post-abortion rehabilitation. Observations have been carried out

for two years. An assessment of efficacy, tolerance, and effect on menstrual

cycle after induced abortions and the duration of the use of theses medicaments

have been made.

Results: It has been detected that only 35% of

adolescents used the contraceptives. The efficacy has made up 100%, the rate of

the following pregnancies has been 11.5% for two years in the control group.

Side effects in the form of marked headaches has been observed in 5.1%, no

negative effect on the mammary glands have been noted as well as on the body

mass. Menstrual cycle restoration after induced abortions with the use of COC

occurred during 2–3 weeks; none of inflammations in reproductive system have

been registered. Sixty-five per cent (119) refused hormonal contraception due to

psychological factors.

Discussion: Application of hormonal contraception has

lead to an early restoration of menstrual cycle and reduces of post-abortion

inflammations. A high rate of COC withdrawal may be connected with traditional

in Russia birth regulation by way of abortions and lack of knowledge of the

adolescents about modern methods of contraception.

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