İSMET GÜN, Murat MUHCU, Ali BABACAN, Vedat ATAY

Postpartum amenore ve gebelikten korunma

Postpartum amenore, gebeliğin sonu ile menstrüasyonun başlangıcı arasındaki zamandır. Postpartum amenorenin uzunluğu, oldukça çeşitlidir ve birçok faktöre bağlıdır. Emzirmenin doğal kontraseptif etkisi yıllardır bilinir. Laktasyonel amenore döneminde yeterince emzirme gebelikten en az %98 korur. Yinede, bu dönemde post partum kontraseptif bir metoda ihtiyaç vardır. Postpartum amenore kadının reproduktif yaşamı ve onların sağlığı için önemli bir olaydır. Laktasyonel infertilitenin mekanizması açıkça anlaşılmış değildir. Bu derlemenin amacı postpartum dönemde ovulasyon ve menstrüasyonun geri dönüşü ve korunma yöntemlerini tartışmaktır.

Post-partum amenorrhoea and contraceptive

Post-partum amenorrhoea is the period from the end of pregnancy to begin of menstruation. The length of postpartum amenorrhea is quite variable, and depends on several factors. The natural contraceptive effect of breast feeding has been known for years. Adequatel breast-feeding during lactational amenorrhoea is at least 98% effective of protection from pregnancy. However, there is needed a post-partum contraceptive method in this period. Post-partum amenorrhea is an important event for females' reproductive life and their health. The mechanism of lactational infertility is not clearly understood. The objective of this study is to discuss the contraception methods for postpartum women and return time of ovulation in the postpartum period.

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1. Aryal TR. Retrospective reporting of the duration of post-partum amenorrhea: a survival analysis. Kathmandu Univ Med J (KUMJ). 2006; 4(2): 211-7.
2. Yadava KN, Jain SK. Postpartum amenorrhoea in rural eastern Uttar Pradesh, India. J Biosoc Sci. 1998; 30(2): 227-43.
3. Aryal TR. Differentials of post-partum amenorrhea: a survival analysis. JNMA J Nepal Med Assoc. 2007; 46(166): 66-73.
4. Labbok MH. Effects of breastfeeding on the mother. Pediatr Clin North Am. 2001; 48(1): 143-58.
5. Gray RH, Campbell OM, Apelo R, Eslami SS, Zacur H, Ramos RM et al. Risk of ovulation during lactation. Lancet. 1990; 335(8680): 25-9.
6. Labbok MH, Colie C. Puerperium and breastfeeding. Curr Opin Obstetr Gynecol. 1992; 4(6): 818-25.
7. Van der Wijden C, Kleijnen J, Van der Berk T. Lactational amenorrhoea for family planning. In: The Cochrane Library. Issue 1. Oxford. 2004.
8. Kennedy KI, Visness CM. Contraceptive efficacy of lactational amenorrhoea. Lancet. 1992; 339(8787): 227-30.
9. Shaaban MM, Kennedy KI, Sayed GH, Ghaneimah SA, Abdel-Aleem AM. The recovery of fertility during breastfeeding in Assiut Egypt. J Biossoc Sci. 1990; 22(1): 19-32.
10. Chao S. The effect of lactation on ovulation and fertility. Clin Perinatol. 1987; 14(1): 39-50.
11. Vekemans M. Postpartum contraception: the lactational amenorrhea method. Eur J Contracept Reprod Health Care. 1997; 2(2): 105-11.
12. Truitt ST, Fraser AB, Grimes DA, Gallo MF, Schulz KF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2003; 2: CD003988.
13. Kennedy KI. Post-partum contraception. Baillieres Clin Obstet Gynaecol. 1996; 10(1): 25-41.
14. Egbuonu I, Ezechukwu CC, Chukwuka JO, Ikechebelu JI. Breast-feeding, return of menses, sexual activity and contraceptive practices among mothers in the first six months of lactation in Onitsha, South Eastern Nigeria. J Obstet Gynaecol. 2005; 25(5): 500-3.
15. Grimaldi L, De Giorgio F, Andreotta P, D'Alessio MC, Piscicelli C, Pascali VL. Medicolegal aspects of an unusual uterine perforation with multiload-Cu 375R. Am J Forensic Med Pathol. 2005; 26(4): 365-6.
16. Short RV, Lewis PR, Renfree MB, Shaw G. Contraceptive effects of extended lactational amenorrhoea: beyond the Bellagio Consensus. Lancet. 1991; 337(8743): 715-7.
17. Neville MC. Physiology of lactation. Clin Perinatol. 1999; 26(2): 251-79.
18. Labbok MH. Healt sequel of breastfeeding for the mother. Clin Perinatol. 1999; 26(2): 491-503.
19. Edozien L. The contraceptive benefit of breastfeeding. Afr Health. 1994; 16(6): 15-7.
20. Badraoui MH, Hefnawi F. Ovarian function during lactation. Popul Sci. 1982; 2: 95-107.
21. Nath DC, Land KC, Singh KK. The role of breastfeeding beyond postpartum amenorrhoea on the return of fertility in India: a life table and hazards model analysis. J Biosoc Sci. 1994; 26(2): 191-206.
22. Nath DC, Goswami G. Determinants of breast- feeding patterns in an urban society of India. Hum Biol. 1997; 69(4): 557-73.
23. Howie PW, Mcneilly AS. Breast-feeding and postpartum ovulation. IPPF Med Bull. 1982; 16(2): 1-3.
24. Shaaban OM, Glasier AF. Pregnancy during breastfeeding in rural Egypt. Contraception. 2008; 77(5): 350-4.
25. Singh KK, Suchindran CM, Singh RS. Smoothed breastfeeding durations and waiting time to conception. Soc Biol. 1994; 41(3-4): 229-39.
26. Khella AK, Fahim HI, Issa AH, Sokal DC, Gadalla MA. Lactational amenorrhea as a method of family planning in Egypt. Contraception. 2004; 69(4): 317-22.
27. Wyss P, Maroni E. The risk of conception during lactation. Geburtshilfe Frauenheilkd. 1993; 53(12): 825-8.
28. Gun I, Salman MC. The diagnostic and therapeutic approach to intraabdominal contraceptive device. Balkan Military Medical Review. 2008; 11(2): 84-6.
29. Mc Laren A. A history of contraception: from antiquity to the present day. Oxford. Basil Blackwell Press, 1990.
30. Özvarış SB, Dervişoğlu AA. Operational research for an effective information and training apporach for surgical contraception knowledge and attitude in Turkey. Nüfus Bilim Dergisi 1996; 17-18: 41-53.
31. ACOG practice bulletin Emergency oral contraception. International Journal of Gyn& Obst. 2002; 78: 191-8.
32. Gupta P, Hewitt G: Update on emergency contrception. Rewiews in Gyneacological Practice. 2002; 2: 5-9.