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  • Title: Randomised clinical trial to determine optimum initiation time of norgestrel-progestin only contraception in Eldoret Teaching Hospital, Kenya.
    Author: Were EO, Kendall JZ, Nyongesa P.
    Journal: East Afr Med J; 1997 Feb; 74(2):103-7. PubMed ID: 9185396.
    Abstract:
    In a randomised controlled trial to determine the optimum time of initiation of Ovrette, a progestin only oral contraceptive among postpartum women, who fully or nearly fully breast-fed their infants in the first six months, no difference was found between group 1 (initiating at six weeks postpartum) and group 2 (initiating the pill at return of menses or 6 months postpartum). There were no pregnancies in either group during the 18 month follow-up. There were no significant differences in the continuation rates between the two group. The optimal time for initiation of progestin-only oral contraception (POC) among fully or nearly fully breast-feeding women was investigated in a comparative study conducted among 200 women delivering at Kenya's Eldoret Teaching Hospital in a 2-year period during 1992-94. 100 women were randomly assigned to initiate POC use at 6 weeks' postpartum (group 1), while the remaining 100 women deferred POC initiation until the onset of menses or 6 postpartum months (whichever event occurred first) (group 2). At 12 months postpartum, 53.57% of mothers in group 1 and 56.67% in group 2 were still taking Ovrette; at 18 months, these rates were 46.10% and 43.59%, respectively. The mean duration of use was 7.6 months in group 1 and 7.5 months in group 2. There were 178 episodes of adverse experiences with Ovrette, 16.9% of which involved menstrual disturbances. Adverse experiences were more likely to be perceived as serious and related to Ovrette in group 1 than in group 2. There were no pregnancies recorded, suggesting that initiation of Ovrette use at 6 months postpartum or when menses reappears is a feasible strategy. However, postpartum women should be provided with counseling on the efficacy of the lactational amenorrhea method.
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