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Related Experiment Videos

Interventions for emergency contraception.

L Cheng1, A M Gülmezoglu, C J Oel

  • 1International Peace Maternity and Child Health Hospital (IPMCH), China Welfare Institute, 145 Guangyuan Road, 910 Hengshan Road, Shanghai, China, 200030.

The Cochrane Database of Systematic Reviews
|July 22, 2004
PubMed
Summary

Levonorgestrel and mifepristone are highly effective emergency contraception methods. Levonorgestrel offers a simpler single-dose option, while the Yuzpe regimen is a viable alternative when other methods are unavailable.

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Area of Science:

  • Reproductive Health
  • Pharmacology
  • Evidence-Based Medicine

Background:

  • Emergency contraception (EC) is underutilized globally, increasing risks of unsafe abortions and maternal mortality.
  • Available EC interventions include IUDs, Yuzpe regimen, levonorgestrel, mifepristone, and danazol.
  • Comparative data on EC efficacy, safety, and convenience is vital for healthcare providers and patients.

Purpose of the Study:

  • To identify the most effective, safe, and convenient emergency contraceptive method for preventing pregnancy after unprotected intercourse.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials and controlled clinical trials.
  • Searched multiple databases including Cochrane, Popline, and MEDLINE, with expert and pharmaceutical company contact.

Related Experiment Videos

  • Data extraction and quality assessment performed independently by two reviewers; meta-analysis used fixed-effects model (RR, 95% CI), with random-effects model for heterogeneity.

    • Main Results:

    • Levonorgestrel demonstrated higher efficacy than the Yuzpe regimen (RR: 0.51; 95% CI: 0.31 to 0.83).
    • Single-dose levonorgestrel showed similar effectiveness to split-dose administration.
    • Levonorgestrel and mifepristone (low to mid-doses) exhibited comparable efficacy; mifepristone's main side effect is dose-related menstrual delay.

    Conclusions:

    • Levonorgestrel (single or split dose) and low/mid-dose mifepristone are highly effective EC methods with acceptable side-effect profiles.
    • Single-dose levonorgestrel simplifies EC use without increased side effects; mifepristone may cause anxiety due to menstrual delay.
    • The Yuzpe regimen is an alternative if levonorgestrel or mifepristone are unavailable; IUDs are also effective for EC and ongoing contraception.