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Tropical Journal of Obstetrics and Gynaecology

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Contraception With Medroxyprogesterone Injections in Port Harcourt, Nigeria.

Anthony O.U. Okpani, Paul L. Kua

Abstract


Context: Depot medroxyprogesterone acetate (Depo Provera®) contraception is effective but associated with menstrual side effects that cause discontinuations among acceptors. Experience with its use in Port Harcourt has never been reported before.


Objective: Evaluation of the effectiveness, acceptability and side effects of Depo Provera in Port Harcourt clients and comparison with experience elsewhere.




Methods: Collection of data on Depo Provera contraception at the University of Port Harcourt Teaching Hospital (UPTH) Family Planning Clinic between 1st August 1986 and 31st July 1995 from client records. Information obtained included proportion of new clients accepting Depo Provera, socio-demographic characteristics, number of injections received, side effects including accidental pregnancies, and discontinuations.



Results: Depo Provera (1870 new acceptors) accounted for 32% of all non-barrier contraception during the study period. The mean [± SD] age and parity of the 1541 acceptors whose files were available were 31.6 ± 3.3 years and 5.8 ± 2.3 respectively. Multiple side effects (total 1611 episodes) occurred with 87% of these, mostly related to menstruation. Secondary amenorrhoea was reported by 53.7% of the study subjects. Five accidental pregnancies occurred (Pearl Index 0.22 per hundred woman years). Defaults from scheduled injections and discontinuations of use were common with a low continuation rate (7.6%) at the end of the observation period. Secondary amenorrhoea was responsible for 33.3% of discontinuations.



Conclusion: The efficacy and side effects of Depo Provera in Port Harcourt are similar to those reported elsewhere. Defaults from injections and high discontinuations in our study subjects suggest low motivation for contraception.



Key Words: Contraception, Progestin, Provera, Acceptability, Injectable.



[Trop J Obstet Gynaecol, 2002, 19: 107-111]



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