Levonorgestrel intrauterine system continuation rate after induced abortion: a 5-year evaluation.
ESC Congress Library. Vaz de Macedo C. May 28, 2014; 50592; A-177 Disclosure(s): None to disclose.
Dr. Carolina Vaz de Macedo
Dr. Carolina Vaz de Macedo
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1. Objectives
Levonorgestrel intrauterine system (IUS LNG) is a well-known long acting contraceptive method (LARC); intrauterine devices have a 2% failure cumulative rate in 5 years and, for IUS LNG in particular, this rate is estimated on 0,5%, with an efficacy comparable to surgical sterilization. Induce abortion is legal in Portugal since 2007.One of our crucial concerns is repeated abortion, which can be minimized by a consistent strategy of contraception shortly after the abortion. The main purpose of this study was the evaluation of IUS LNG continuation rate in women from our Family Planning Unit after induced abortion.

2. Method
Women with a recent history of induced abortion were included. The IUS LNG insertion was performed 3 weeks after the abortion. Clinical files were evaluated from 2007 (July) to 2011 (December), with analysis for at least 5 years for a total of 122 cases. Data collection included: age, bleeding patterns, continuation rate and reasons for discontinuation. Descriptive statistics were conducted and data are presented as absolute values, percentages, mean and standard deviation (SD).

3. Results
The mean (±SD) age is this group was 35.7±6.79 years (range 20-54). The continuation rate was 41.3±13.57 months (range 12-97), with 94 women (77%) maintaining the same contraceptive method after 5 years. A change to a different contraceptive method occurred in 8 cases (6.5%), 4 of which were due to expulsion of the IUS LNG. Loss to follow-up was acknowledged in 20 women (16.3%). Of women for whom the bleeding pattern was registered at 12 months (n=76), regular menses was reported is 34 cases, oligomenorrhea in 19, amenorrhea in 13, irregular bleeding in 6 and hypomenorrhea in 4 cases.

4. Discussion
Long acting reversible contraception is strongly recommended in women after induced abortion supposing that contraception methods with long duration will reinforce efficacy on contraception and therefore minimize repeated abortion. The results in this sample of women with induced abortion in a long term analysis, show a high continuation rate (77%, with a mean value of 41.3 months of use) of IUS LNG. As such, this method should be considered as an actual long acting contraceptive alternative for women after induced abortion.

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