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韓國婦人에 있어서의 子宮內避姙裝置의 避姙效果에 關한 硏究

A Study on Effectiveness of Intra-uterine Contraceptive Device with Korean Women

공중보건잡지 1966년 3권 2호 p.79 ~ 87
김탁일,
소속 상세정보
김탁일 (  ) - 서울대학교 의과대학 예방의학교실

Abstract


In order to gauge efficacy and acceptability of the intra-uterine contraceptive device or the Jack Lippes´ Loop now in widescale use among the Korean women a follow-up observation was carried out during the period from October to December 1965 towards 3,204 married women in Seoul City who had adopted intra-uterine contraception in the period from July 1964 to September 1965. The analysis of the data thus obtained led the Author to the following major findings :
1. Among the reasons for removals of loops after their initial insertions, the removals for medical reasons represented 94 per cent ranking highest, while the removals for personal reasons 2 per cent and irrelevant reasons 4 per cent, respectively.
2. The monthly rate of removals for medical reasons has been measured at 10.1 per cent or the highest within the first month period after the initial insertion, which declined sharply starting in the second month. In contrast, the rates of removal for personal and irrelevant reasons did not demonstrate any noticeable shift in the successive periods after the insertion.
3. The cumulative rates of removals to the end of first year after the initial insertions have been computed at 31.5±1.2 per cent for medical reasons, 0.9±0.2 per cent for personal reasons and 1.5±0.3 per cent for the reasons irrelevant.
4. The rates of spontaneous expulsions of loops turned out to be highest within the first month period after the initial insertion (2.7 per cent) and declined gradually thereafter, the cumulative expulsion rate to the end of the first year after the insertion having been computed at 11.0±0.8 per cent.
5. The monthly rates of pregnancies taking place while loops were in use maintained a range of 0.2∼0.3 per cent regardless of the length of period of observations after the initial insertion. The cumulative pregnancy rate as of the end of the first year period after the insertion has been computed at 2.9±0.4 per cent.
6. The reinsertion of loops rated 10 per cent or lowest for the cases of removals for medical reasons. rating 44 per cent and 11 per cent for cases of removals for personal reasons and for irrelevant reasons, respectively. The reinsertions by cases of spontaneous expulsions rated 42 per cent. The various "drop-out" rates have been adjusted with the rates of reinsertions taken into account. Accordingly, the cumulative rate of removals for medical reasons as of the end of the first year period after insertion turned out to be 28.4 per cent. that for personal reasons 0.5 per cent and for the reasons irrelevant 1.3 per cent. The adjusted cumulative rate for spontaneous expulsions to the end of the first years period has been computed at 6.4 per cent.
7. No visible correlations have been obtained between the reproductive experience in terms of frequency of deliveries, clinical conditions accountable allegedly for the insertion of intra-uterine contraceptive devices and the incidence of pregnancies with devbices in situ. The rates of spontaneous expulsions, however, appeared to tend to become lower with the progress of the frequency of deliveries experienced. This probably suggests a possibility that the spontaneous expulsions of loops might have been caused by the foreign body reactions inherent with the physiology of uterus rather than by the mechanical element involved with the conditions of the cervical canalor the dilatations resulting from frequent deliveries.
8. The combination of all "drop-out" rates cumulatively totaled 42.6±1.2 per cent as of the end of the first year period after the initial insertion, indicating necessities for administrative measures to be taken to supplement the evident drawbacks accompanying a wide-scale use of Lippes´ loops, possible with other contraceptive methods including oral pills.

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