Interní Med. 2002; 4(8): 19-20

Postkoitální antikoncepce

MUDr. Michael Fanta
Gynekologicko-porodnická klinika 1. LF UK a VFN v Praze

Keywords: postcoital contraception, Yuzpe method, levonorgestrel.

Published: December 31, 2002  Show citation

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Fanta M. Postkoitální antikoncepce. Interní Med. 2002;4(8):19-20.

Postkoitální antikoncepce (-emergency contraception-) je metoda zabraňující otěhotnění po nechráněném pohlavním styku, podává se většinou do 72 hodin od koitu. Užití vysokých dávek estrogenů k zabránění implantace, diethylstilbestrolu (25-50 mg denně) a ethinylestradiolu, bylo zkoušeno Morrisem a van Wagenem již od 60. let minulého století. Extrémní dávky estrogenů však byly spojeny s velmi vysokým výskytem gastrointestinálních nežádoucích účinků. V roce 1972 zavedl Yuzpe schéma užití kombinované postkoitální antikoncepce, které přineslo snížení dávek hormonů při zachování účinnosti.

Nejčastějšími důvody použití některé z metod postkoitální antikoncepce jsou selhání bariérové metody (kondomu), vynechání tablety hormonální antikoncepce a nechráněný pohlavní styk (bez jakékoliv formy antikoncepce) (3).

POSTCOITAL CONTRACEPTION

Postcoital contraception, i. e. the so-called -emergency contraception-, is a method to prevent pregnancy after unprotected sex and it should be administered within 72 hours from a sexual intercourse. From the sixties of the last century Morris and van Wagen experimented with the use of high doses of estrogens for the impedence of implantation (25-50 mg of die-thylstilbestrol qd and ethinyl estradiol). This extreme estrogen dosage was linked to a high occurrence of gastrointestinal side effects. In 1972 Yuzpe introduced a novel scheme for the use of a combined emergency contraception characterized by preserving the efficacy and, at the same time, lowering the hormonal doses. The most frequent reasons for using one of the methods of emergency contraception are a failure of the barrier method (condom), an omission of a tablet during oral contra-ceptive use and an unprotected coitus (without any previous contraception).

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References

  1. Aubény E. Can hormonal emergency contraception (EC) be available without medical prescription?, The 6th Congress of the European Society of Contraception Ljubljana June 2000. Contraception and Reproductive Health Care 2000; 5: 1: 41.
  2. Aubény E, Chatellier G. A randomized comparison of mifepristone and self-administered oral or vaginal misoprostol for early abortion, Contraception and Reproductive Health Care 2000; 5, 3: 171-176. Go to original source... Go to PubMed...
  3. Bigrigg A. Improving knowledge of access to emergency contraception, The 6th Congress of the European Society of Contraception, Ljubljana, June 2000. Contraception and Reproductive Health Care 2000; 5, 1: 23.
  4. Čepický P, Holub Z, Hořejší J, Rokyta Z, Uzel R. Postkoitální kontracepce. Česká gynekol 2001; 66, 5: 378-380. Go to PubMed...
  5. Falk G, Falk L, Hanson U, Mislom I. Young women requesting emergency contraception have a high frequency of new unintended pregnancies despite counselling, The 6th Congress of the European Society of Contraception, Ljubljana, June 2000, Contraception and Reproductive Health Care 2000; 5, 1: 39.
  6. Glasier A. Emergency postcoital contraception. N Engl J Med 1997; 337: 1058. Go to original source... Go to PubMed...
  7. Rowlands S, Devalia H, Lawrenson R, et al. Repeated use of hormonal emergency contraception by younger women in the UK, The 6th Congress of the European Society of Contraception, Ljubljana, June 2000, Contraception and Reproductive Health Care 2000; 5, 1: 40.
  8. Sitruk-Ware R. The role of antiprogestins in contraception, The 6th Congress of the European Society of Contraception, Ljubljana, June 2000. Contraception and Reproductive Health Care 2000; 5, 1: 21.
  9. Task Force on Postovulatory Methods of Fertility Regulation. Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Lancet 1998; 352: 428-433. Go to original source...




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