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Clinical Experience with Progestogen-only Injectable Contraception in Southern Nigeria: A Ten-Year Review

This study presents a ten-year review of the sociodemographic characteristics, acceptance, safety profile, and efficacy of progestogen-only injectable contraception (POIC) in a tertiary institution in Southern Nigeria.

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Clinical Experience with Progestogen-only Injectable Contraception in Southern Nigeria: A Ten-Year Review

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  1. CLINICAL EXPERIENCE WITH PROGESTOGEN ONLY INJECTABLE CONTRACEPTION IN A TERTIARY INSTITUTION SOUTHERN NIGERIA:A TEN YEAR REVIEW Oranu E.O., Ojule J.D., Enyindah C.E., Okpani A.U University Port Harcourt Teaching Hospital, Port Harcourt

  2. BACKGROUND Progestogen-only injectable contraceptive (POIC) is a reversible and widely accepted contraceptive methods. POIC was one of the contraceptive options at the commencement of family planning clinic at the UPTH Commonly associated with menstrual irregularities. It seems a common choice among contraceptive users. However observation suggest a declining use. Decided d/4 to subject this obs to scientific scrutiny.

  3. To determine the socio demographic characteristic, ACCEPTANCE , safety, profile and the efficacy of POIC in our centre OBJECTIVES

  4. INTRODUCTION Fertility rate high in developing countries (approx 6) 1 Contraceptive prevalence low (15.8%) in Nigeria 2 POIC popular means of contraception 3,4 Main MOA is inhibition of ovulation

  5. Hence ed Efficiency (Pearl Index • 0) 5. • Non-contraceptive advantage:dysmenorrhea ectopic gestation, • PID, • Adverse effects irregular vaginal bleeding, weight gain, headache, mood changes. Minimal service provider user attention =improveing compliance

  6. METHODOLOGY • 10 years retrospective study at UPTH family plan clinic. • Duration 2004 – 2013: • Family planning physicians, • Nurse and support staff • Injection DMPA or NOR-ENT: 150m and 200m respectively given 2 monthly and 3 monthly. • No massaging

  7. Follow up visit, complaints, BP, wt gain and urinalysis are documented in pt files • Data on sociodemographicxteristics, source of information, side effects, unplanned pregnancy extracted using a profoma. • Analyzed using SPSS window version 19.0, P-value of 0.05 was used. • Results were expressed in figures and percentages and presented in tables and graph.

  8. RESULTS • Out of the 7,001 new acceptors of contraceptive at UPTH within period under review, 1075 POIC • Hence acceptance rate was 15.35% • Spacers 57.1% and Limiter 42.9%. • condom, IUD, POIC(3rd), Implant.

  9. Figure 1 : Showing Yearly Distribution of Acceptors of POIC from 2004 - 2013

  10. Table 1 Biodata A Age Distribution

  11. Majority of the clients belonged to age group 30-34, mean 32.11+4.93yr • Mean age and mean parity of limiters (34.77 yrs and 4.88 deliveries) > that of the spacers (30.12yr and 2.76 deliveries) (P-value 0.05) • 85.9% of our client had a minimum of secondary education-- counseling easy • All were married. • Mass media contributed only 5.8% to the source of information

  12. Table 2 Complications of injectable contraceptives

  13. 57 (5.3%) discontinued. • 856 (79.6%) were lost to follow up. • Secondary Amenorrhea and weight gain • 72.7% and 14.7% resp. • . Pearl index was zero • . Implanon and Jadelle introduced in 2006 and 2008 resp.

  14. Appears a downward trend in POIC usage from 2008, then 2011. • Condom, IUD, POIC(3rd), Implants • A shifting trend to LARC noted

  15. CONCLUSION • POIC remain a common contraceptive option for our clients. • Effective and relatively safe. • Initial lending position is increasingly being challenged. • Demand for LARC gradually increasing.

  16. REFERENCES

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