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.
