Faculty Bibliography

OBJECTIVE: To estimate the effectiveness, side effects, and retention rate of the levonorgestrel two-rod implant used as a long-acting contraceptive. METHODS: Voluntary participants, ages 18-40 years and desiring long-acting contraception, were enrolled in the study. The original design was to observe the participants for 5 years. Later, the follow-up period was extended to 6 years. RESULTS: A total of 249 women underwent two-rod implant insertion and were observed for a total of 823 woman-years. There were two pregnancies observed during the study, yielding a pregnancy rate of 0.24 per 100 woman-years. One pregnancy occurred in the first month, and the other occurred after 6 years of use. The major side effect was menstrual irregularity. No serious side effects were observed during the study. Insertion of the device was easy and took less than 2 minutes; removal time averaged 4.5 minutes. CONCLUSION: The levonorgestrel two-rod implant system is an effective, convenient, long-acting, and well-tolerated method of contraception

A new approach to terminate very early pregnancy was tried on 49 healthy women who were proven to be pregnant from 31 to 47 days from their last menstrual period. All pregnancies were confirmed either by UCG or serum HCG-B subunit. (15S)-15-Methyl PGF2 alpha Methyl Ester in a suppository form was administered in two separate doses: 1.0 mg initial dose followed by 3.0 mg one hour later. Patients were kept under observation for 8 hours. Blood sampling for progesterone, HCG-B, and prostaglandin levels were assayed at 0 degree, 30', 1 degree, 4 degrees, 8 degrees and 14 days. Patients were re-examined at a two week follow-up visit. Pelvic examination and pregnancy tests were performed to confirm whether the pregnancy was successfully terminated. There were no significant changes in serums progesterone and HCG-B levels during the 8-hour observation period. Both levels declined significantly to very low levels at 14 days post-therapy, confirming the clinical impression of successful termination of pregnancy. Plasma prostaglandin levels rose as early as 30 minutes after initiation of therapy, peaked at 4 hours and declined gradually afterwards. Most side effects such as nausea, vomiting, diarrhea and cramps, although clinically manageable, were still bothersome. One patient experienced an episode of vasovagal syncope. The majority of patients required medical observation up to 6 hours. Clinical implications of this new approach of termination of very early pregnancy are discussed