familyplanning计划生育.ppt

FamilyPlanning GynecologicalDepartment The3rdaffiliatedHospital SYSUZhangYu Highlights Mechanism indication contraindication sideeffectsandcomplicationofcontraception hormonalcontraception intrauterinedevice Indication contraindicationandcomplicationofsterilizationIndication contraindicationandcomplicationofinducedabortion Section1 Contraception Contraception HormonalContraception IntrauterineDevice IUD Others HormonalContraception HormonalContraception Oralcontraception OCContraceptiveinjectionContraceptivedeliverysystem Oralcontraception Short actingoralcontraceptivesMonophasicBiphasicTriphasic moreandmorewidespread Vacationpills Oralcontraception Short actingoralcontraceptivesMonophasicBiphasicTriphasic moreandmorewidespread Vacationpills Contraceptiveinjection Long actingSingleprogesterone combinedtypeOnemonth threemonths Contraceptivedeliverysystem ImplantationVaginalringMicrospheresandmicrocapsulesinjectionContraceptivepatch Mechanismofhormonalcontraception Mechanismofhormonalcontraception Mechanismofhormonalcontraception PreventingovulationAlteringthecervicalmucusAlteringtheendometriumAlterthefunctionofoviducts Indicationofhormonalcontraception Child bearingageNocontraindictionHealthywomen Contraindicationofhormonalcontraception SeriouscardiovasculardiseasesAcuteandchronichepatitis ornephritisBlooddiseaseorthromboticdiseasesEndocrinediseaseCancer precancerouslesions uterineorbreastlumpsLactationperiodMenstrualrareorolderthan45yearsoldUnexplainedvaginalbleedingMentaldisease Sideeffectsofhormonalcontraception Nausea dizziness fatigue drowsiness lossofappetiteBreakthroughbleedingMissedmenstrualperiodsoramenorrheaWeightgainPigmentationHeadache breasttenderness increasedappetite itching Sideeffectsofhormonalcontraception Endometrialcancer cervicalcancer breastcancer epithelialovariancancerFertility 80 ovulationin3months 95 98 ovulationinayearOffspringhealthImpairedglucosetolerance increaseofHDL triglyceridetotalproteindecreasedThromboembolicdisease IntrauterineDevice IUD IntrauterineDevice IUD InertintrauterinedevicesActivityIUD withcopperwithdrugsprogesterone Mirena indomethacinothers Mirena Mechanism IUD Mobilizationofleukocytes produceanenvironmenthostile influencethemovementoftheoviductsInterferenceofendometrialmaturationCopperdevice killsperm interruptionofcellmetabolismProgesterone releasingdevice alterationofnormaltubalcilialaction disruptionofnormaloocytematuration Mechanism Mirena Indication IUD WomenofchildbearingageNocontraindictionWithVoluntaryrequirements Contraindication IUD PregnancyorpregnancysuspectedInflammationofgenitaltractTumorofgenitaltractMenorrhagia frequentmenstruation irregularvaginalbleedingUterineinjurydiseasesGenitalmalformations Contraindication IUD AbnormaluterinecavitySeveresystemicdiseasevenerealdiseasePelvictuberculosisPooruterinecontraction residual inflammationafterabortion deliveryorcesareansectionCopperallergy Insertiontime IUD 3 7daysaftermenstruationDelayedmenstruation lactationamenorrhea ruleoutpregnancy42dayspostpartumDuringabortionorcesareansection Insertionsteps Mirena Sideeffects complication IUD Duringinsertion bleeding uterineperforationAfterinsertion infection ectopic crack deformationofIUD menstrualabnormalities vaginaldischargeincreased pelvicinfection ectopicpregnancy Othercontraception Topicalcontraceptives condom femalcondom contraceptivediaphragm vaginalspermicidesNaturalfamilyplanning 20 failurerateBiotechnologycontraception LHRHa immunocontraception anti fertilityvaccine Section2 Sterilization Tubalsterilizationoperation Safe permanentHighreversibilitySurgicalapproach laparotomy tuballigation laparoscopy transvaginal Indication tuballigation VoluntaryNocontraindictionTherapeuticsterilization Contraindication tuballigation PelvicinflammatorydisesesAbdominalskininflammation2timesofT 37 5 in24hrsCannottoleratesurgeryduetosystematicdiseasesSeverneurosis Preparation tuballigation Timechoice 3 7daysaftermenstruation duringabortion deliveryorcesareansectionGoodexplanationHistory physicalexamination bloodandurinelaboratoryexaminationGynecologicalabdominalsurgerypreparation Anesthesia tuballigation localinfiltrationanesthesiaIntravenousanesthesiaEpiduralanesthesiaEndotrachealintubationanesthesia Steps tuballigation Emptyingthebladder disinfectionofSurgicalfieldIncitionExtracttubeExtinguishtubeLigatetube UchidamethodCheck closeabdomen Complication tuballigation BleedingorhematomaInfectionOrgandamageSterilizationfailure Section3 Remedialmeasuresforcontraceptionfailure Inducedabortion Inducedabortion early mid pregnancy medicalabortion artificialabortion Vacuumsuction Curettage Vacuumsuction Indication pregnanciesof10weeks durationorless WithVoluntaryrequirementswithoutcontraindiction CannotcontinuethepregnancyduotodiseaseContraindiction emergencystageofalldiseases Inflammationofgenitaltract 2timesofT 37 5 beforeoperation Poorhealthysituation Steps Vacuumsuction PreparationDetectuterinecavityDilatecervixVacuumsuctionCheck Steps Vacuumsuction Curettage 10 14pregnancygestationSufficientlydilatecervixGraduallydisplacedbymedicalabortion Complication artificialabortion UterineperforationIntegratedresponsetoabortionIncompletesuctionFailuresuctionBleedingInflammationEmbolismLacerationofcervixAdhesion pelvicinfection abnormalmenstruation endometriosis infertility medicalabortion Pharmacologyofmifepristone MisoprostolGestation 7weeks 18 40yearsoldUterine