Pencegahan Kehamilan... Untuk Wanita Berkahwin Sahaja :)

Kali ni entry ni hanya sesuai dibaca oleh WANITA YANG TELAH BERKAHWIN... PERINGATAN SEKALI LAGI... WANITA YANG TELAH BERKAHWIN...

Sadi rasa ramai wanita zaman sekarang ni yang ingin merancangan kehamilan... buat wanita yang terlalu SUBUR... pelbagai kaedah untuk mencegah kehamilan boleh diambil... kali ini sadi nak share info berkenaan dengan pencegah kehamilan antara IMPLANON dan IUCD

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IMPLANON

Implanon, made by Organon International, is a single-rod contraceptive subdermal implant that is inserted just under the skin of a woman's upper arm. The 4 cm by 2 mm Implanon rod contains 68 milligrams of the gonane progestin etonogestrel which is released over a three year period. This product can maintain ovulation suppression and contraceptive efficacy. However, Implanon may be removed at any time, but must be removed after three years.

Implanon was first approved for use in Indonesia in 1998, was subsequently approved for use in over 30 other countries, and has been used by over 2.5 million women worldwide. Implanon was approved for use in the United States by the FDA on July 17, 2006.

Insertion
Local anaesthetic is applied to the upper arm, and then a needle-like applicator is used to insert the implanon rod under the skin. The procedure can take less than a minute. Implant site complications are experienced by 3.6% of patients, and include swelling, redness, hematoma and pain.

Side effects and risks
There are notable side effects caused by Implanon that occur in some women. Irregular periods or prolonged bleeding, headaches, acne, weight gain and abdominal pain were among the most commonly reported side effects in clinical trials. Eleven percent of women had Implanon removed because of irregular menstrual bleeding, which can include excessive menstrual bleeding. Some women may have no menstrual period at all while using Implanon.It is not known whether Implanon changes a woman's risk for breast cancer. Failure rate for Implanon was reported at 0.1%. Most cases of failure were due to incorrect insertion or insertion during pregnancy. In comparison, surgical sterilization has a failure rate of 0.2%. Implanon has also been shown to induce mild insulin resistance.

Fertility after Implanon
Within a few days of having Implanon removed the hormones released by Implanon will have left the body. The chances of becoming pregnant should be the same as they were before using Implanon.

Complications
Complications which can occur include:
* impalpability of implant
* broken or damaged implant
* slight migration
* fibrosis.
If Implanon is "impalpable"—cannot be felt—an ultrasound must be performed. Surgery under local or general anesthesia may be required to remove an impalpable Implanon implant, especially if it is broken, damaged, has migrated, or is deeply embedded in scar tissue or fibrosis.


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IUCD (Intra uterine contraceptive devices)

Types of IUCD
1. Medicated IUCD
2. Non medicated IUCD:


MECHANISM OF ACTION OF IUCDs

1. Prevent implantation of the fertilized oocyte

2. Produce a local sterile inflammatory reaction in the endometrium as a result of presence of foreign body causing spermicidal effect and the presence of cupper increases this reaction and also increases the local release of prostaglandins thus decreasing the rate of pregnancy

3. They diminish sperm transport through the cervix to the oviduct by increasing the thickness of the cervical mucous (this happens with the hormonal IUCD).

4. Steroid releasing devices induce progestational changes that result in endometrial gland atrophy& Inhibit further development of the ova.

TIME OF INSERTION

The optimal time for insertion of IUCD is during the menstrual cycle at any day of the week following menstruation which indicates that the woman is not pregnant.

After delivery either vaginally or by caesarian section; an eight week delay seems to be adequate .IUDs specifically designed for immediate post partum insertion are now available.

An IUCD can be inserted immediately after spontaneous or therapeutic abortion but the risk of expulsion is increased in the second trimester abortion.

REMOVAL OF IUCD

Unless pregnancy is desired, removal should only be undertaken in the late luteal phase of the cycle or the first 7days of the cycle.

In menopausal women IUD should be left in situ for one year after the last menstrual cycle.

If the thread is not visible, IUD should be removed using a specially designed hook or a pair of artery forceps preferably under ultra sound guidance.

UNDESIRABLE EFFECTS OF IUCD

1. MENSTRUAL DISTURBANCES

This includes both regularity and the amount of blood loss i.e. menstrual cycles become prolonged and heavier (menorrhagia) and also may cause dysmenorrhea.

In contrast levenorgestril releasing IUDs decrease the monthly blood loss.

2. PERFORATION

This can occur at the time of insertion .It occurs in 1.3 of every 1000 insertion. It may be best prevented by straightening the uterine axis through pulling the tenaculum which holds the cervix and by performing a bimanual examination to check if the uterus is anteverted or retroverted before attempting to insert the IUCD.

3. EXPULSION

Rate of expulsion varies from 1_7/100 women in first year of use. Expulsion is commoner in the first 3 months of use so every woman should be examined frequently and should be taught to feel the thread of the IUD vaginally frequently.

4. PELVIC INFECTION

This is caused by bacteria carried into the uterus during the procedure. However the development of pelvic inflammatory disease after insertion usually results from a sexually transmitted pathogen. Salpingitis, tubo- ovarian abscess or pelvic peritonitis and tubal blockage could be the consequences of these bacterial infections. Symptomatic pelvic inflammatory disease is frequently treated with antibiotics without removing the IUD until the patient becomes symptom free, then a new IUD should be inserted under aseptic technique.

5. PREGNANCY ON TOP OF IUCD
This occurs if the IUCD is not in its proper place in the endometrial cavity (slightly low or tilted) so an intra uterine pregnancy may ensue.


ECTOPIC PREGNANCY

Because IUCD prevents intrauterine pregnancy but not ectopic pregnancy, the relative incidence of ectopic could be higher in IUD users.

SPONTANEOUS ABORTION

A spontaneous abortion rate of up to55% has been reported in women becoming pregnant on top of IUD which is not removed after the diagnosis of pregnancy. However if IUD appendage is visible it should be removed or spontaneously expelled, abortion rate diminish significantly thereafter. If it is not visible, it is not advisable to perform uterine probing because of the possibility of abortion, perforation and/or sepsis.

PREMATURITY

Preterm deliveries have been reported in pregnant patients with an IUCD in situ.

EFFICACY

Throughout the years, pregnancy rate among IUD users have been steadily dropping .Non medicated IUDs and copper IUDs (up to 200) had up to 3% pregnency rates.

RELATIVE CONTRAINDICATIONS

1. Nulliparity
2. Valvular heart disease and cardiomyopathy
3. Previous ectopic pregnancy
4. Moderate to severe anemia
5. Hypermenorrhea or menorrhagia
6. Wilson's liver disease
7. Copper allergy
8. AIDS
9. High risk of STD

ABSOLUTE CONTRAINDICATIONS

1.Cardiomyopathy
2.Recent acute pelvic inflammatory disease
3.Chronic or recurrent PID
4.Recent septic abortion
5.Acute cervical or vaginal infection
6.Congenital uterine anomalies
7.Uterine tumors
8.Undiagnosed uterine bleeding


Appropriate Candidates for Intrauterine Contraception

Women of any reproductive age seeking long-term, highly effective contraceptive

CONCLUSION

The benefit of IUCD use surpasses its risks and these are the risks of unwanted pregnancy. IUCDs are highly recommended for most women seeking contraception in developing countries because it has the highest continuation rate and the lowest cost…….

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Jadi... yang mana satu lebih baik... IMPLANON atau IUCD.... hmmmm.... terpulang laa buat setiap individu...

MORAL OF THE STORY: Anak adalah anugerah ALLAH... kita kena menerima setiap anugerahnya... NAMUN... perancangan keluarga juga penting agar dapat melahirkan UMAT ISLAM yang mempunyai KUALITI yang baik....