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Emergency contraception methods: efficacy, safety and acceptability

https://doi.org/10.21518/2079-701X-2021-13-42-49

Abstract

Prevention of unwanted pregnancies, abortions and their complications is one of the major problems of healthcare. The most effective method of unwanted pregnancies prevention is family planning with highly effective contraceptive methods. Currently number of unwanted pregnancies cases is still numerous. Problem of unwanted pregnancy cannot be solved completely with any method of contraception. Every fourth pregnancy in the world is considered as unplanned, more than half of them end in abortion, which can pose a threat to health of the patient. Overall, more than 90% of abortions are performed due to unwanted pregnancies. Emergency contraception continues to play an important role in family planning today. It is known that the effectiveness of emergency contraception decreases with the time after unprotected sex. Today a variety of emergency contraception methods exists, which allows individual approach to specific patient. The article presents the results of randomized clinical trials and meta-analyses evaluating all currently used methods of emergency contraception from the evidence-based point of view. The article also describes drugs specifics, features, and effects on the reproductive system.

About the Authors

P. R. Abakarova
Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Russian Federation

Patimat R. Abakarova, Cand. Sci. (Med.), Research Associate of Research Polyclinic Department

4, Academician Oparin St., Moscow, 117997, Russia



K. I. Gusakov
Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Russian Federation

Kirill I. Gusakov, Cand. Sci. (Med.), Research Associate of Research Polyclinic Department

4, Academician Oparin St., Moscow, 117997, Russia



E. R. Dovletkhanova
Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Russian Federation

Elmira R. Dovletkhanova, Cand. Sci. (Med.), Senior Research Associate of Research Polyclinic Department

4, Academician Oparin St., Moscow, 117997, Russia



E. A. Mezhevitinova
Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology
Russian Federation

Elena A. Mezhevitinova, Dr. Sci. (Med.), Lead Research Associate of Research Polyclinic Department

4, Academician Oparin St., Moscow, 117997, Russia



References

1. Bearak J., Popinchalk A., Alkema L., Sedgh G. Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model. Lancet Glob Health. 2018;6(4):e380–e389. https://doi.org/10.1016/S2214-109X(18)30029-9.

2. Cleland J. The complex relationship between contraception and abortion. Best Pract Res Clin Obstet Gynaecol. 2020;62:90–100. https://doi.org/10.1016/j.bpobgyn.2019.04.007.

3. Ganatra B., Gerdts C., Rossier C., Johnson B.R.Jr., Tunçalp Ö., Assifi F. et al Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model. Lancet. 2017;390(10110):2372–2381. https://doi.org/10.1016/S0140-6736(17)31794-4.

4. Sukhikh G.T., Serov V.N. (eds.). Obstetrician-gynecologist tactics: practical guidelines in 2 parts Moscow: GEOTAR-Media; 2020. Pt. 2. 320 p. (In Russ.) Available at: https://bookmos.ru/components/com_jshopping/files/img_products/taktika-vracha-akushera-ginekologa-prakticheskoe-rukovodstvov-2-h-chastyah-komplekt-2020-978-5-9704-5588-3.pdf.

5. Batur P., Kransdorf L.N., Casey P.M. Emergency Contraception. Mayo Clin Proc. 2016;91(6):802–807. https://doi.org/10.1016/j.mayocp.2016.02.018.

6. Trussell J., Raymond E.G., Cleland K. Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy. Contemporary Readings in Law and Social Justice. 2014;6(2):7–38. Available at: https://www.researchgate.net/publication/242730608_Emergency_Contraception_A_Last_Chance_to_Prevent_Unintended_Pregnancy.

7. Berry-Bibee E., Curtis K., Dragoman M., Gaffield M.L., Jatlaoui T., Kim C. et al. Medical eligibility criteria for contraceptive use. 5th ed. Geneva: World Health Organization; 2015. Available at: https://www.who.int/reproductivehealth/publications/family_planning/MEC-5/en.

8. Prilepskaya V.N. Contraception guideleines. 4th ed. Moscow: MEDpressinform; 2017. 464 р. (In Russ.)

9. Durand M., del Carmen Cravioto M., Raymond E.G., Durán-Sánchez O., De la Luz Cruz-Hinojosa M., Castell-Rodríguez A. et al. On the mechanisms of action of short-term levonorgestrel administration in emergency contraception. Contraception. 2001;64(4):227–234. https://doi.org/10.1016/s0010-7824(01)00250-5.

10. Hamoda H., Ashok P.W., Stalder C., Flett G.M., Kennedy E., Templeton A. A randomized trial of mifepristone (10 mg) and levonorgestrel for emergency contraception. Obstet Gynecol. 2004;104(6):1307–1313. https://doi.org/10.1097/01.aog.0000146286.60138.47.

11. Arowojolu A.O., Okewole I.A., Adekunle A.O. Comparative evaluation of the effectiveness and safety of two regimens of levonorgestrel for emergency contraception in Nigerians. Contraception. 2002;66(4):269–273. https://doi.org/10.1016/s0010-7824(02)00337-2.

12. Prilepskaya V.N., Mgeryan A.N. Emergency hormonal contraception (literature review). Ginekologiya = Gynecology. 2017;19(1):10–14. (In Russ.) Available at: https://cyberleninka.ru/article/n/ekstrennaya-gormonalnayakontratseptsiya-obzor-literatury.

13. Shen J., Che Y., Showell E., Chen K., Cheng L. Interventions for emergency contraception. Cochrane Database Syst Rev. 2017;8(8):CD001324. https://doi.org/10.1002/14651858.CD001324.pub5.

14. von Hertzen H., Piaggio G., Ding J., Chen J., Song S., Bártfai G. et al. Low dose mifepristone and two regimens of levonorgestrel for emergency contraception: a WHO multicentre randomised trial. Lancet. 2002;360(9348):1803–1810. https://doi.org/10.1016/S0140-6736(02)11767-3.

15. Marions L., Hultenby K., Lindell I., Sun X., Ståbi B., Gemzell Danielsson K. Emergency contraception with mifepristone and levonorgestrel: mechanism of action. Obstet Gynecol. 2002;100(1):65–71. https://doi.org/10.1016/s0029-7844(02)02006-9.

16. Xiao B.L., Von Hertzen H., Zhao H., Piaggio G. A randomized double-blind comparison of two single doses of mifepristone for emergency contraception. Hum Reprod. 2002;17(12):3084–3089. https://doi.org/10.1093/humrep/17.12.3084.

17. Mori D., Ogino N., Yonezawa T., Kawaminami M., Kurusu S. Anti-ovulatory effects of RU486 and trilostane involve impaired cyclooxygenase-2 expression and mitotic activity of follicular granulosa cells in rats. Prostaglandins Other Lipid Mediat. 2011;94(3–4):118–123. https://doi.org/10.1016/j.prostaglandins.2011.02.002.

18. Rodriguez M.I., Gülmezoglu A.M. Mifepristone for emergency contraception: Case for recommendation in practice guidelines. Contraception. 2020;102(6):383–384. https://doi.org/10.1016/j.contraception.2020.08.005.

19. Prilepskaya V.N. (ed.). Contraception: from menarche to menopause. Moscow: MEDpress-inform; 2015. 352 p. (In Russ.)

20. Sukhykh G.T., Prilepskaya V.N., Mezhevitinova E.A., Nazarova N.M., Pavlovich S.V., Donnikov A.E., Gevorkyan G.A. Contraception in women of reproductive age. Moscow: Binom; 2019. (In Russ.)

21. Wilcox A.J., Weinberg C.R., Baird D.D. Timing of sexual intercourse in relation to ovulation. Effects on the probability of conception, survival of the pregnancy, and sex of the baby. N Engl J Med. 1995;333(23):1517–1521. https://doi.org/10.1056/NEJM199512073332301.

22. Maksimov M.L., Tolstykh T.T. Сomparison of the effectiveness of the available methods of emergency contraception. Lechebnoe delo = Medical Business. 2012;(4):58–62. (In Russ.) Available at: https://cyberleninka.ru/article/n/ekstrennaya-kontratseptsiya-sravnenie-effektivnostiprimenyaemyh-metodov/viewer.

23. Piaggio G., Kapp N., von Hertzen H. Effect on pregnancy rates of the delay in the administration of levonorgestrel for emergency contraception: a combined analysis of four WHO trials. Contraception. 2011;84(1):35–39. https://doi.org/10.1016/j.contraception.2010.11.010.

24. Dikke G.B. Awareness about the effectiveness and safety of emergency contraception - a reserve in the prevention of unwanted pregnancy. Meditsinskiy sovet = Medical Council. 2016;(2):92–95. (In Russ.) https://doi.org/10.21518/2079-701X-2016-2-92-95.

25. Adanu R., Amaral E., Cameron S. Chipato T., Chou R., Conard J. Selected practice recommendations for contraceptive use. Available at: https://www.who.int/reproductivehealth/publications/family_planning/SPR-3/en/.

26. Dada O.A., Godfrey E.M., Piaggio G., von Hertzen H. A randomized, doubleblind, noninferiority study to compare two regimens of levonorgestrel for emergency contraception in Nigeria. Contraception. 2010;82(4):373–378. https://doi.org/10.1016/j.contraception.2010.06.004.

27. Trussell J., Ellertson C., Stewart F. The effectiveness of the Yuzpe regimen of emergency contraception. Fam Plann Perspect. 1996;28(2):58–64. Available at: https://pubmed.ncbi.nlm.nih.gov/8777940/.

28. Ellertson C., Webb A., Blanchard K., Bigrigg A., Haskell S., Shochet T., Trussell J. Modifying the Yuzpe regimen of emergency contraception: a multicenter randomized controlled trial. Obstet Gynecol. 2003;101(6):1160–1167. https://doi.org/10.1016/s0029-7844(03)00353-3.

29. Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Task Force on Postovulatory Methods of Fertility Regulation. Lancet. 1998;352(9126):428–433. Available at:https://pubmed.ncbi.nlm.nih.gov/9708750.

30. Zhang L., Chen J., Wang Y., Ren F., Yu W., Cheng L. Pregnancy outcome after levonorgestrel-only emergency contraception failure: a prospective cohort study. Hum Reprod. 2009;24(7):1605–1611. https://doi.org/10.1093/humrep/dep076.

31. Levy D.P., Jager M., Kapp N., Abitbol J.L. Ulipristal acetate for emergency contraception: postmarketing experience after use by more than 1 million women. Contraception. 2014;89(5):431–433. https://doi.org/10.1016/j.contraception.2014.01.003.

32. Rarick L.D. Prescription drug products; certain combined oral contraceptives for use as postcoital emergency contraception. Federal Regist. 1997;62:8610–8612. Available at: https://www.govinfo.gov/content/pkg/FR-1997-02-25/pdf/97-4663.pdf.

33. Trussell J., Hedley A., Raymond E. Ectopic pregnancy following use of progestin-only ECPs. J Fam Plann Reprod Health Care. 2003;29(4):249. https://doi.org/10.1783/147118903101197944.

34. Cleland K., Raymond E., Trussell J., Cheng L., Zhu H. Ectopic pregnancy and emergency contraceptive pills: a systematic review. Obstet Gynecol. 2010;115(6):1263–1266. https://doi.org/10.1097/AOG.0b013e3181dd22ef.

35. Curtis K.M., Berry-Bibee E., Folger S.G., Horton L.G., Jamieson D.J., Jatlaoui T.C. U.S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm Rep. 2010;59(RR-4):1–86. Available at: https://pubmed.ncbi.nlm.nih.gov/20559203/.

36. Prilepskaya V.N., Abakarova P.R., Bebneva T.N. Five-year experience in emergency contraception of National Center. Ginekologiya = Gynecology. 2004;6(6):313–315. (In Russ.) Available at: https://elibrary.ru/item.asp?id=21106245.


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For citations:


Abakarova PR, Gusakov KI, Dovletkhanova ER, Mezhevitinova EA. Emergency contraception methods: efficacy, safety and acceptability. Meditsinskiy sovet = Medical Council. 2021;(13):42-49. (In Russ.) https://doi.org/10.21518/2079-701X-2021-13-42-49

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ISSN 2079-701X (Print)
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