减肥手术后女性的避孕咨询和避孕用法评估。,Obesity Surgery

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减肥手术后女性的避孕咨询和避孕用法评估。
Obesity Surgery ( IF 2.9 ) Pub Date : 2019-12-01 , DOI: 10.1007/s11695-019-04084-z
Michiel A Damhof ₁ , Esther Pierik ₂ , Lisanne L Krens ₃ , Marloes Vermeer ₄ , Marc J van Det ₅ , Eric N van Roon _{2,

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Affiliation

背景技术根据美国和欧洲的指南，建议在减肥手术后的12-24个月内避免生育年龄的妇女怀孕。吸收不良的减肥手术后，口服避孕药的疗效可能欠佳。目的本研究的目的是评估荷兰两家肥胖诊所接受减肥手术的妇女在手术前后的避孕药具使用情况。此外，还调查了避孕和妊娠咨询的召回情况。方法从2017年10月至2018年8月，对年龄在18-45岁的女性进行减肥手术，并进行了有效的问卷调查。结果，共有230名女性符合最终分析的条件。术后60％使用安全避孕，16.1％不安全避孕和23.9％无避孕。在这项研究中，43。7％的妇女在术前使用了潜在的不安全避孕方法，在术后转为安全避孕方法（p <0.0001）。仅有62.6％的女性证实主要在术前接受过避孕咨询。与未接受避孕咨询相比，接受避孕咨询和使用安全避孕方法的比值比为2.20（95％CI，1.27-3.79； p = 0.005）。83％的人确认他们已接受有关延迟怀孕的咨询，并且52.6％的人熟悉避免在术后24个月内怀孕的建议。结论在我们的研究中，有60％的女性术后使用安全避孕方法。避孕咨询的效果不佳，因为接受咨询的回忆率为62.6％。确认接受咨询的人在减肥手术后更可能使用安全的避孕方法。建议在术后和门诊进行更多的咨询和监测。

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Assessment of Contraceptive Counseling and Contraceptive Use in Women After Bariatric Surgery.

BACKGROUND Reproductive-aged women are, according to American and European guidelines, recommended to avoid pregnancy for 12-24 months after bariatric surgery. Oral contraceptives may have suboptimal efficacy after malabsorptive bariatric procedures. AIM The aim of this study was to assess contraceptive use pre- and postoperatively in women who underwent bariatric surgery in two obesity clinics in The Netherlands. Also, the recall of contraceptive and pregnancy counseling was investigated. METHODS A validated questionnaire was performed among women aged 18-45 years who underwent bariatric surgery from October 2017 through August 2018. RESULTS In total, 230 women were eligible for final analysis. Postoperatively, 60% used safe contraception, 16.1% unsafe contraception, and 23.9% no contraception. In this study, 43.7% of women using a potential unsafe contraceptive method preoperatively switched to a safe method of contraception postoperatively (p < 0.0001). Only 62.6% of women confirmed to have received contraceptive counseling, mainly preoperatively. The odds ratio for receiving contraceptive counseling and using safe contraceptive methods compared with not receiving contraceptive counseling was 2.20 (95% CI, 1.27-3.79; p = 0.005). Eighty-three percent confirmed that they have received counseling regarding delaying a pregnancy, and 52.6% were familiar with the recommendation to avoid a pregnancy for 24 months postoperatively. CONCLUSIONS In our study, 60% of women are using safe contraception postoperatively. Contraceptive counseling is suboptimal as 62.6% recall receiving counseling. Those who confirmed receiving counseling were more likely to use safe contraception after bariatric surgery. More counseling and monitoring in the postoperative and in the outpatient setting is recommended.

更新日期：2019-11-01

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