妇产科学精品教学（重庆医科大学）15Family planning.pptVIP

Family planning Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Chongqing Medical University Ou Wenjun 欧文君 Summary Family planning enables sexually active couples to prepare for their pregnancies, in order to optimize both fetal and maternal outcomes. Fertility control? Avoid unwilling pregnancy Unplanned pregnancies constitute major public health problems. Chapter 1 Contraception Methods of contraception Intrauterine device, IUD Hormonal contraception Other contraceptive methods IUD Convenience, cost effectiveness and reversibility For women who are in stable, mutually monogamous relationships at low risk for sexually transmitted infections (STIs) Most commonly used in China→80% History of IUD Used in animals at first 1909, the first human IUD, designed by a German doctor named Richard Richter, was made of silk Aseptic technique→modern IUD Ancient IUDs Categories of modern IUDs IUDs wound with copper wire Different shapes Different surface areas of copper The levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena) Release levonorgestrel 20ug/d Suitable for women with heavy menses or dysmenorrheal Modern IUDs TCu-380 TCu375 母体乐 Mechanisms of contraception Mechanisms of contraceptive action of IUDs Kill the sperm or fertilized ovum by Mobilization of leukocytes in response to the presence of the foreign body Leukocytes may produce an environment hostile to the fertilized ovum Spermicidal activity with copper devices Prevent implantation by Disruption of endometrial maturation with the progesterone-releasing device Alteration of normal tubal action Disruption of normal oocyte maturation Indications to the use of IUDs Women of childbearing age with no contraindication who accept IUD Uterine cavities sound to 6cm-9cm Parous women in a mutually monogamous relationship who do not have a current or prior history of STDs or salp