contraception的方式很多，有激素（药物），宫内节育器，物理性隔离（比如condom），化学性隔离（杀精剂），生理避孕，结扎等。在RN/CGFNS考试中经常会考到这一类的知识，但是有的书上对这些内容描述很不全面，这里总结了一些相关的避孕方式，副作用，禁忌症等，希望大家能掌握这些知识，在考试中能顺利地答对题目。

      Hormonal contraceptives(pill,避孕药):

      主要包括Estrogen, Progesterone, Androgen

      Side effect(especially estrogen):  abnormal menstruation，breast cancer，liver    toxicity, fluid  retension,thromboembolism, migraine headaches 

Contraindication: liver disease, thromboembolic, coronary artery disease, hypertension,decrease in glucose tolerance(diabetics), renal disease, gallbladder disease

       note: emergency postcoital contraceptives should be taken within 72 hours of unprotected coitus

 

       Intrauterine devices (IUDs,也就是我们常说的上环)

side effect: Uterine perforation, infection, heavy bleeding, spotting between periods,prolonged periods, cramping

Contraindications: PID, pregnancy, undiagnosed genital bleeding, genital malignancy, abnormal uterine cavity

 

       Diaphragm (避孕隔膜,性交前置入女性阴道内)

No side effects from well-fitted device if woman is not allergic to diaphragm or spermicide

       Contraindications: vaginal bleeding , hard to fit, genital infection, allergy,toxic shock syndrome

       Note: Insert up to 6 hr before intercourse and leaving in place for 6 hr after last intercourse, but no longer than 24 hr；Size/fit must be checked after term birth, second/third trimester abortion, weight gain or loss of 15-20 Ib, every 2 years；clean with warm water and mild sop, powder with cornstarch and store away from heat

 

       Cervical cap(宫颈帽,性交前置入女性宫颈处,注意事项类似避孕隔膜)

Contraindications: abnormal Pap smear, hard to fit, genital infection, allergy, toxic shock syndrome

       Note: Worn for 8 hr but not longer than 48 hr.Size/fit must be checked after term birth, second/third trimester abortion, weight gain or loss of 15-20 Ib, every 2 years

       clean with warm water and mild sop, powder with cornstarch and store away from heat

      Pap smear every year

 

       Condom(安全套)

        No side effect except allergy to latex

        Protect from STDs(the only method).

        Use with water soluble jelly, cream, spermicidal foam

 

       Spermicide(杀精剂)

       Side effecti: allergy

       Note: each intercourse should be preceded (30 min) by a fresh application

 

 

        Natural family planing(自然避孕,安全期避孕)

        BBT each morning before any physical activity

       Body T decrease slightly when ovulating then decreased 0.5 degree below base T

        Requireds sexual abstinence(or use of condom) during woman's fertile period ( 4 days before ovulation and 3-4 days after ovulation)

 

        Ligation(结扎）

        Male: Vas deferens is occluded with band or clip to prevent passage of sperm

side effect: some men become impotent due to psychological response to procedure, fertility after tubal reconstruction

        Female: Both fallopian tubes are ligated and severed with bands or clip to prevent passage of eggs.

        complications: infection, hemorrhage, trauma to other organs