Contracepcao de emergencia
From: Flavio Monteiro de Souza (flavioms@uninet.com.br)
Sat, 31 Jul 1999 00:59:11 -0300
Localizei este artigo que compara a contacepcao de emergencia pelo metodo de
Yuzpe (o tradicional, com 200 mcg de etinil estradiol associado a 1000 mcg
de levonorgestrel dividido em 2 doses, ou seja, 2 pilulas de Evanor ou
Neovlar repetidas 12 horas depois) com o levonorgestrel 750 mcg em 2 doses
o "lancamento" discutido ha' poucos dias na lista). Parece que o
levonorgestrel puro obtem melhores resultados, possivelmente pela menor
ocorrencia de efeitos colaterais (vomitos).
--
Flavio Monteiro de Souza
Prof. Assistente - Obstetrícia - UERJ
flavioms@uerj.br
flavioms@uninet.com.br
Title
Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of
combined oral contraceptives for emergency contraception. Task Force on
Postovulatory Methods of Fertility Regulation [see comments]
Source
Lancet, 1998 Aug, 352:9126, 428-33
Abstract
BACKGROUND: A previous randomised study suggested that the progestagen,
levonorgestrel, given alone in two separate doses each of 0.75 mg caused
nausea and vomiting in fewer women and might be more effective than the
Yuzpe regimen of combined oral contraceptives for emergency contraception,
although the difference was not significant. We compared these two regimens
when started within 72 h of unprotected coitus. METHODS: We enrolled in the
double-blind, randomised trial 1998 women at 21 centres worldwide. Women
with regular menses, not using hormonal contraception, and requesting
emergency contraception after one unprotected coitus, received
levonorgestrel (0.75 mg, repeated 12 h later) or the Yuzpe regimen
(ethinyloestradiol 100 microg plus levonorgestrel 0.5 mg, repeated 12 h
later). FINDINGS: Outcome was unknown for 43 women (25 assigned
levonorgestrel, 18 assigned Yuzpe regimen). Among the remaining 1955 women,
the crude pregnancy rate was 1.1% (11/976) in the levonorgestrel group
compared with 3.2% (31/979) in the Yuzpe regimen group. The crude relative
risk of pregnancy for levonorgestrel compared with the Yuzpe regimen was
0.36 (95% CI 0.18-0.70). The proportion of pregnancies prevented (compared
with the expected number without treatment) was 85% (74-93) with the
levonorgestrel regimen and 57% (39-71) with the Yuzpe regimen. Nausea (23.1
vs 50.5%) and vomiting (5.6 vs 18.8%) were significantly less frequent with
the levonorgestrel regimen than with the Yuzpe regimen (p<0.01). The
efficacy of both treatments declined with increasing time since unprotected
coitus (p=0.01). INTERPRETATION: The levonorgestrel regimen was better
tolerated and more effective than the current standard in hormonal emergency
contraception. With either regimen, the earlier the treatment is given, the
more effective it seems to be.
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Administrador da lista: flavio.monteiro.desouza@obgyn.net
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Última atualização: Mon May 19 16:37:44 2008
