Long Acting Reversible Contraception in Adolescents with Cardiovascular Conditions

作者：Oelschlager Anne Marie E Amies^*; Micks Elizabeth A; Debiec Katherine E; Nizamic Tiana; Mantrala Malica D; Prager Sarah W

来源：Journal of Pediatric and Adolescent Gynecology, 2014, 27(6): 353-355.

DOI：10.1016/j.jpag.2014.01.102

• Intrauterine device
• Etonogestrel implant
• Cardiac
• Cardiovascular
• Adolescent
• Contraception

Study Objective: The purpose of this case series was to evaluate the efficacy and complication rate with use of long-acting reversible contraceptive (LARC) methods in adolescents with cardiovascular conditions.
Design and Participants: We performed a retrospective chart review of adolescents age 22 or younger with congenital cardiac anomalies or major cardiovascular conditions who had a LARC device placed at Seattle Children's Hospital or University of Washington Medical Center between January 1, 2007 and March 1, 2012.
Main Outcome Measures: Patient characteristics, medical conditions, indications, and complications including perforation, pregnancy, expulsion, and pelvic infection were collected and analyzed.
Results: Thirty adolescents with congenital cardiac anomalies or other cardiovascular conditions had a LARC device inserted during the study period. Mean age at placement was 17.7 years (range 12-22). Twelve patients (40%) had reported a previous pregnancy and 12 (40%) had never been sexually active at time of placement. Common primary and secondary indications were desired contraception (22 patients, 73%), desired menstrual suppression (15 subjects, 50%) and treatment of heavy menstrual bleeding (8 subjects, 27%). Twenty-nine patients had a structural cardiac anomaly. There were 27 levonorgestrel-releasing intrauterine devices (IUD), 1 copper IUD, and 3 etonogestrel implants placed. There were 2 confirmed IUD expulsions and 1 removal due to persistent irregular bleeding and cramping. There were no cases of pelvic inflammatory disease or pregnancies with LARC methods in place. Twenty-seven (90%) patients were continuing LARC at last follow-up.
Conclusions: In this small case series of adolescents with cardiovascular conditions, LARC devices were effective at pregnancy prevention without serious complications.

• 出版日期2014-12