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Progestogen injection (DMPA)

Progestogen injection (DMPA). Depo -provera. -depot-medrexy progesterone acetate . - one type of progestogen is Depo-Provera. - given deep intramuscular . -given in dose of 150 mg at 12 weeks interval. *advantages. - very effective method. -long term pregnancy prevention , but reversible .

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Progestogen injection (DMPA)

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  1. Progestogen injection (DMPA)

  2. Depo -provera • -depot-medrexy progesterone acetate . • - one type of progestogen is Depo-Provera. • - given deep intramuscular . • -given in dose of 150 mg at 12 weeks interval .

  3. *advantages • - very effective method. • -long term pregnancy prevention , but reversible . • -no interference with sex . • -no daily pill taking ,no need to remember . • - allows some flexibility in return visit (client can return as much as 2-4 weeks early ). • -used at any age .

  4. -does not affect breast milk ( quality & quantity ). • -no estrogen side effect & complication . • -it prevent ectopic pregnancy . • -it prevent endometrial cancer . • -it prevents uterine fibroids. • -it may prevent ovarian cancer. • -it may prevent iron deficiency anemia . • -may make seizures less frequent in women with epilepsy .

  5. *disadvantages: • -light spot or bleeding in the first . • Heavy bleeding then amenorrhea ,especially after 1st year . • -weight gain . • -delayed return of fertility (5-7) months . • -may cause headache ,breast tenderness ,moodiness ,nausea ,& acne in some woman . • -does not prevent against STIs.

  6. ** use: • @ having menstrual cycle: • -initial injection is usually given within the 1st five days of menstrual period . • -if given in the 1st day , contraceptive effect is immediate . • @ after miscarriage: • -immediately or in the first 7 days of abortion . • -later at any time woman certain that she is not pregnant .

  7. @breast feeding : • fully breast feeding prevent pregnancy effectively for at least 6 months ,or till menstruation return . • -DPMA can be given as extra protection . • -if not breast feeding , it may be used immediately or at any time in the first 6weeks after childbirth .

  8. **midwifery intervention : • Instruct woman to come back on time for next injection . • If more than two weeks late for next injection, use condom ,spermicidal or avoid sex . • Instruct woman to come back to clinic for ask question (if she was late on her time ). • Mention to her the most common side effect .

  9. Invite woman to come back at any time she needs ,help with any problem ,or want different method . • The injection given IM deeply don’t message the site of injection (fast absorption ) .

  10. Female & Male sterilization • female sterilization through bilateral tubal ligation , this operation is done under general anesthesia . • consent form should be taken from both (wife & husband ) • age of mother above 35 years old . • male sterilization is done under local anesthesia ,through an incision done in secrotum ,ligation of vase deference through operation called vasectomy • hematoma & infection are common complication , so continuous local support for 2 weeks will reduce bruising

  11. sample of semen is usually examined at 3-4 months post op. • sterilization is permanent method of family planning & efficacy is 99.9%

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