RESUMEN
To investigate relative efficacy of intrauterine diclofenac and ibuprofen as adjuvants to intrauterine quinacrine for nonsurgical sterilization, a total of 900 women were systematically allocated to 2 monthly insertions of pellets of diclofenac (75 mg) or ibuprofen (55.5 mg) as adjuvants to intrauterine quinacrine (216 mg) in a rural private practice in West Bengal, India. All women were prescribed oral contraceptives for three months from first insertion. In the middle of the study increased care was taken to insert pellets at the fundus. There was no statistically significant difference found in cumulative life-table pregnancy failure rates at 36 months for women receiving diclofenac (2.7 +/- 0.82) or ibuprofen (3.4 +/- 0.89). Taking care to insert pellets at the fundus resulted in a decline of failures at 24 months from 4.4 +/- 0.92 to zero. Intrauterine administration of pellets of quinacrine (216 mg) plus diclofenac (75 mg) or ibuprofen (55.5 mg) with 3 months' oral contraception provides acceptable efficacy if pellets are inserted to the fundus.
Asunto(s)
Diclofenaco/administración & dosificación , Ibuprofeno/administración & dosificación , Quinacrina/administración & dosificación , Esterilización Reproductiva/métodos , Útero/efectos de los fármacos , Femenino , Humanos , India , EmbarazoRESUMEN
Two preliminary single-insertion clinical trials of the quinacrine pellet method of non-surgical female sterilization were compared. Both trials used transcervical application of quinacrine, 252 mg, and diclofenac, 75 mg, as pellets. In the first trial (21 April 1992 to 17 February 1993), 58 women received oral contraceptives for three months. In the second trial (19 February 1993 to 25 May 1994), 229 women received medroxyprogesterone acetate, 150 mg IM, at the time of quinacrine insertion. At 18 months, the life-table pregnancy failure rate per 100 women of the first trial was 8.6 (SE 3.7), whereas the failure rate for the medroxyprogesterone acetate group was 0.5 (SE 0.5), p<0.05. There were no serious complications or side-effects in either group. Larger confirming trials with random allocation and long-term systematic follow-up are needed to determine whether a single injection of medroxyprogesterone improves the efficacy of quinacrine.
Asunto(s)
Trompas Uterinas/efectos de los fármacos , Quinacrina/administración & dosificación , Esterilización Reproductiva/métodos , Cuello del Útero , Anticonceptivos Orales , Diclofenaco/administración & dosificación , Femenino , Humanos , Acetato de Medroxiprogesterona/administración & dosificación , EmbarazoRESUMEN
In the Howrah District in India, three clinics--one in each of the urban, slum, and rural areas of the city--were initiated by the Humanity Association of Howrah in November of 1968 to supply oral contraceptives (OCs) to women from 15 to 45 years of age. The project was discontinued in September, 1972. Of the 1700 patients still active when the project ended, 1527 were contacted for the follow-up survey. Findings indicate that most women in this district were satisfied with OCs and would continue to use them if they were available. In corroboration of this, it was found that 43% of the women had used OC'S obtained from other sources after the project was discontinued. While 35.5% of the women who used no contraceptive method after project ended reported becoming pregnant or suspected that they were pregnant at the time of the interview, only 4.2% of those who reported using some form of contraception reported pregnancy or suspected pregnancy. The demographic impact of the project will be evaluated on the basis of data to be obtained in a subsequent survey of the same communities.