To Observe The Clinical Effect Of Yaz Compare With Yasmin After Surgical Abortion In Chinese Population

Abortion is the remedy for contraceptive failure.Avoiding or reducing unwanted pregnancy is the real purpose of family planning work.The number of induced abortions in China increased from 39,10,110 in 1971 to 96,and 26,731 in 2017,the proportion of induced abortions in family planning operations increased from 30%in 1971 to 50.60%in 2017.The situation of induced abortion in China is severe.According to the official statistics of China,there are 13 million cases of abortion per year,which are characterized by a large number of young aged having a large number of unborn children frequently and in short intervals.Induced abortion seriously affects women's physical and mental health.After operation bleeding,infection,uterine perforation,induced abortion syndrome,aspiration insufficiency,leakage,intrauterine adhesions,chronic pelvic inflammation,menstrual disorders,secondary infertility and other short term and long term complications can occur also.Repeated abortion on women's reproductive health caused greater harm,the more induced abortion,the higher incidence of abortion complications and sequelae.Studies have shown that 88.2%of women with secondary infertility have had an abortion.Women who had repeated abortions were 2.5 times more likely to have abortions in normal childbearing than those who have no abortion history,and the premature birth rate is 5.44 times more likely to have one abortion.Domestic and foreign data show that ovulation after abortion can occur as early as 11 days after surgery.52%of young women said that they could not put an end to sexual behavior after an operation,they had no urgent requirement for contraception,and it did not matter for another abortion.To protect and improve women's reproductive health,publicized contraceptive knowledge,standardize women's care services after abortion,strengthen the awareness of immediate contraception,implement effective contraceptive methods and adhere to correct use,The China Women's Development Foundation,the Family Planning Credit Society of the Chinese Medical Association and the Science and Technology Research Institute of the National Population and Family Planning Commission jointly launched the "Post-Abortion Care Project".After abortion placing IUD immediately,giving oral contraceptives and subcutaneous contraceptives have been listed in the Routine of Clinical Technical Operation and Family Planning Fascicle.Yaz and Yasmin are the most popular combination of short-acting oral contraceptives in China.The main components are drospirenone and ethinylestradiol.These drugs are widely used in China after induced abortion,with the purpose of contraception,regulate menstruation,reduce short-term and long-term complications,and protecting female reproductive ability.Yasmin contains 3 mg of drospirenone and 0.03 mg of ethinylestradiol.Yaz contains 3 mg of drospirenone and 0.02 mg of ethinylestradiol.Drospirenone is synthetic progesterone similar to spironolactone and is found in many birth control preparations.It is close to natural progesterone and has the activity of anti-salt corticosteroid.Ethinyl estradiol is a semi-synthetic estrogen that acts as an estrogen receptor agonist.Functions of them are to suppress the release of FSH and LH,thereby suppress ovulation.Progesterone can change the characteristics of cervical mucus,so that sperm is not conducive to the crossing.It can also change the shape and function of the endometrium and Change the function of the fallopian tube,So that it's difficult for a fertilized egg to implant.Besides,a small amount of estrogen can promote the repair of the endometrium.In this study,women who had a surgical abortion in The Third Affiliated Hospital of Zhengzhou University were taken as an example to analyze the effect of Yasmin and Yaz used in surgical abortion.ObjectiveTo observe the clinical effect of Yaz compare with Yasmin after surgical abortion in Chinese population.Material and methods1 Object of studyThe study data were selected From May 2015 to December 2016 and November 2018 to March 2019.300 and 70 pregnant women who attended the Obstetrics and Gynecology clinic of the Third Affiliated Hospital of Zhengzhou University and actively requested an abortion.The inclusion criteria were:age 20 to 38 years old,6 weeks to 10 weeks of pregnancy,past physical fitness,regular menstruation,color Doppler ultrasound in our Hospital suggest early intrauterine pregnancy,no contraindications to induced abortion.2 MethodsThe 300 patients were randomly divided into observation group 1 and control group 1.Observation group 1 was given Yasmin,while control group 1 was given condoms and other contraceptive methods.The 70 patients were randomly divided into observation group 2 and control group 2,observation group 2 was given Yaz and control group 2 was given Yasmin.All patients in the observation group and control group 2 were required to be informed and agree to use Yasmin or Yaz,while patients in control group 1 were required to be informed and agree to use other methods of contraception.Before using Yasmin or Yaz,patients should be fully informed about its role,precautions,benefits of the application and possible adverse reaction of the patients in the observation group,choose and sign the agreement.The Observation group 1 and Control group 2 immediately started oral Yasmin treatment(Orally taken daily,1 tablet/day,21 days as a course of treatment,and 3 consecutive courses of treatment).The Observation group 2 immediately started oral Yaz treatment(Orally taken daily,1 tablet/day,24+4 days as a course of treatment,and 3 consecutive courses of treatment).In control group 1,another contraceptive measure such as condoms were used after operation.After 21 days of follow up,the patients were asked about the bleeding time,bleeding volume,adverse drug s reactions,and the endometrial thickness.The patients were followed up for 3 months by telephone and asked about their menstrual period(frequency,amount and duration),The incidence of PMDD(Premenstrual Dysphoric Disorder)symptoms,contraceptive situation,and adverse drug reactions.No patients were lost to follow-up.3 Statistical AnalysisData were analyzed and statistically evaluated using SPSS software,version 21.0 evaluated using SPSS software,Quantitative data was expressed in mean,standard deviation and difference between mean of two groups were compare by Man Whitney U test while qualitative data were expressed in percentage.Statistical differences between the proportions were tested by chi square test or Fisher's exact test.p value less than 0.05 was considered statistically significant.Results1.In the observational group 1(Yasmin)average bleeding time was(4.090±3.539)days and In the control group 1 average bleeding time was(6.692±4.842)days,There was significantly shorter average bleeding time in the observational group 1(Yasmin)than the control group 1(p<0.01).2.In the observational group 1(Yasmin),there were 8 cases with more bleeding volume,accounting for about 5.33%.50 cases with medium bleeding volume,accounting for about 33.33%and 92 cases with less bleeding volume,accounting for about 61.33%,in control group 1,there were 40 patients with more bleeding volume,accounting for 26.67%,98 patients with medium bleeding volume,accounting for 65.33%,12 patients with less bleeding volume,accounting for about 8.00%.There was significantly less bleeding volume in the observational group 1(Yasmin)than the control group 1(p<0.01).3.The endometrial thickness of the observational group 1(Yasmin)was(5.149±1.574)mm,and the endometrial thickness on the control group 1 was(3.733 ±1.790)mm.There was significantly thicker endometrial thickness in the observational group 1(Yasmin)than the control group 1.The results were statistically significant(P<0.01).4.In the observational group 1(Yasmin)contraceptive rate was 100%and In the control group 1 was 94.7%,the contraceptive rate were superior than the control group 1 with statistically significance difference(p<0.01).5.In the observational group2(Yaz)average bleeding time was(3.28 ± 3.31)days and in the control group 2(Yasmin)average bleeding time was(3.92 ± 1.15)days.There was significantly shorter bleeding time in the observational group 2(Yaz)than the control group 2(Yasmin)(p<0.02).6.The endometrial thickness of the observational group2(Yaz)was(1.63 ±1.28)mm,and the endometrial thickness on the control group 2(Yasmin)was(4.41± 1.62)mm.There was significantly thinner endometrial thickness in the observational group 2(Yaz)than the control group 2(Yasmin).The results were statistically significant(P<0.01).7.In observational group 2,there were 3 patients with PMDD symptoms,accounting for about 8.57%.In control group 2,there were 6 patients with PMDD symptoms,accounting for about 17.14%.There was lower incidence of PMDD in observational group 2 than the control group 2(P=0.47).8.There were no cases of unintended pregnancy in observational group 2 and control group 2,and the contraceptive rate of taking Yasmin or Yaz after abortion was 100%.Conclusion1.After abortion oral Yasmin can effectively reduce the post-operative duration of vaginal bleeding,amount of vaginal bleeding and can regulate the cycle.It can promote endometrial growth and It has a good contraceptive effect and less adverse effect.2.Compared with the oral administration of Yasmin after the surgical abortion,the administration of Yaz 24+4 regimens is more convenient.Yaz has stronger ovarian inhibition function that relieves Pre-Menstrual Dysphoric Disorder related symptoms like mood swings,Depression,fatigue,abdominal bloating,hot flash,headache,breast tenderness,weight gain etc,which is worthy of clinical promotion.