Abstract

PIP: During November 1992-November 1994 at Assiut University Hospital in Egypt, 120 of 240 fully lactating women requesting contraception during the second postpartum month chose the nomegestrol acetate contraceptive subdermal implant Uniplant, while the other 120 chose the copper-releasing IUD CuT 380A. This prospective, non-randomized study evaluated the use of Uniplant during lactation. The mothers and their infants were followed-up once a month for 3 months and then every 2 months up to the infants' first birthday. Neither group experienced a pregnancy. Women in the Uniplant group were less likely to have resumed menstruation at 12 months postpartum than those in the IUD group (38% vs. 63%; p 0.001). The 12-month net continuation rates were statistically similar (88.3% for Uniplant users and 92.4% for IUD users). Reasons for IUD discontinuation were infant death (6), lost to follow up (5), irregular bleeding (2), and depression (1). Reasons for Uniplant discontinuation were lost to follow up (4), irregular bleeding (2), moving to a distant residence (2), and infant death (1). The 2 groups were similar in terms of breast feeding episodes, time of weaning, and the cumulative rates of full and partial breast feeding. Health problems (diarrhea, fever, and cough) affected the infants of both groups at similar incidence rates. The infants in both groups had similar weight, weight gain per day, and linear growth. Six of the 7 infant deaths occurred in the Uniplant group. The difference in the infant death rate was not significantly different, however. Gastroenteritis was responsible for 5 infant deaths. Bronchopneumonia and unexplained convulsion claimed the life of 1 infant each. These findings suggest that Uniplant is an acceptable and effective contraceptive method during lactation and has no adverse effect on infant growth and health.