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Non-contraceptive benefits hormonal contraception after abortion (hormonal rehabilitation)

Non-contraceptive benefits hormonal contraception after abortion (hormonal rehabilitation). Moscow Regional Research Center of Obstetrics & Gynecology, Moscow Olga Serova, M.D., professor. Long-term sequelae. Inflammatory diseases Menstrual disorders Reproductive function’ disorders

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Non-contraceptive benefits hormonal contraception after abortion (hormonal rehabilitation)

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  1. Non-contraceptive benefits hormonal contraception after abortion(hormonal rehabilitation) Moscow Regional Research Center of Obstetrics & Gynecology, Moscow Olga Serova, M.D., professor

  2. Long-term sequelae • Inflammatory diseases • Menstrual disorders • Reproductive function’ disorders • High risk complications of subsequent pregnancies • High risk of perinatal pathology • Maternal mortality

  3. Abortion Prevention • Safe abortion technology • Rehabilitation after abortion • Effective contraception

  4. Post-abortion bleeding 6,5 days 6 days 4,5 days Medical abortion Vacuum- aspiration Surgical abortion

  5. Time of first menstrual period after abortion 48,2 40,2 29,1 Medical abortion Vacuum- aspiration Surgical abortion

  6. Surgical abortion Vacuum aspiration Medical abortion Hormonal disorders after abortion 4% 12% 26%

  7. Decidua during medical abortion

  8. Pathmorphological analysis of materials after vacuum aspiration

  9. Pathmorphological analysis of materials after surgical abortion

  10. 7th day’s endometrial after medical abortion

  11. 7th day’s endometrial after vacuum aspiration

  12. 7th day’s endometrial after surgical abortion

  13. Appropriate transformation after medical abortion

  14. Delayed endometrium’ transformation after vacuum aspiration

  15. Incomplete endometrium’ transformation after surgical abortion

  16. Hormonal rehabilitation Medical abortion 3 months Vacuum aspiration 3 months Surgical abortion 3 months • Monophasic COC • Regulon • Microdosis COC • Novinett Monophasic COC Regulon • Monophasic COC • Regulon • Microdosis COC • Novinett

  17. Post-abortion contraception • efficacy • safe • no side-effects • prevention inflammatory diseases

  18. Differential approach to choice of COC Acne, hirsutism Regulon Dismenorrea Regulon Menstrual disorders Regulon PCOS Regulon, Novinett Diabetus melitusNovinett Endometriosis Novinett Obesity Regulon, Novinett Teens/Young age Novinett

  19. Benefits of the desogestrel-containing COC • Efficacy • Acceptability • No side effects (anabolic, androgenic) • No influence on BP, lipid and carbohydrate metabolism

  20. Non-contraceptive benefits of desogestrel-containing COC • Menstrual cycle regulation • Reducing dysmenorrhea symptoms • Reducing blood bleeding • Hyperandrogenia • Endometriosis treatment

  21. Protective effects of desogestrel-containing COC • risk’s of an extrauterina pregnancy • risk’s of an endometrial and an ovarian carcinoma • risk’s of benign mammary gland • risk’s of ovarian cysts and benign ovary’ and uterus’ tumors • risk’s of inflammatory diseases • risk’s of haemorrhage in women with coagulopathy • risk’s of leiomyoma and endometriosis

  22. Follow-up • Control side effects, BP • Laboratory tests in women with somatic diseases (1 time in 6 months) • Pelvic exam, including colposcopy and colpocytology (1 time in a year) • Ultrasound (1 time in a year, in require) • Breast exam (1 time in 6 months), mammography 1 time in a year) and ultrasound(in some indications)

  23. COC benefits • Long application • Return fertility just after stopping • Possibility of cancel in case of side effects or complications

  24. Effectiveness of the rehabilitation after abortion (1 year follow-up)

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