Journal of Contraception Reproductive Health Care - The European ...

The 8th Congress of The European Society of Contraception Abstracts of Free Communications
FC3-07
A collaborative clinic between contraception and sexual health services and the adult congenital heart
disease clinic
P. Rogers (1), D. Mansour (1), A. Mattinson (2), J. J. O’Sullivan (3)
Contraception and Sexual Health Service, Newcastle upon Tyne, UK (1); Associate Specialist, Contraception and Sexual Health Service,
Newcastle upon Tyne, UK (2); Consultant in Paediatric Cardiology, Freeman Hospital, Newcastle upon Tyne, UK (3)
Background: The success of cardiac surgery has created a new medical community – the ‘grown-up’ congenital heart patients.
Women with congenital heart disease may need specialist advice about contraception and pregnancy.
Objective: To investigate whether women with congenital heart disease were receiving appropriate advice on contraception.
Methods: A contraceptive history was taken, via a predetermined form on 46 consecutive female patients, consenting to see a
family planning doctor, at the adult congenital heart disease clinic, Freeman Hospital, Newcastle upon Tyne.
Results: Sixteen women (35%) had never discussed contraception with a health professional. One third of women who had
previously discussed contraception with either their GP or family planning clinic had received inappropriate advice. There had
been eight unplanned pregnancies in seven women. Thirteen out of eighteen women using condoms as their main method of
contraception changed to a more reliable hormonal method. Four out of seven women not using any contraception started on a
hormonal method. Two women changed their hormonal contraception to a more reliable method. There was a poor knowledge
among the women about hormonal methods particularly Depo-provera and Implanon.
Conclusions: There is poor provision of contraceptive advice for women with congenital heart disease. A lot of women are
unaware of the methods available to them. Many women had not received any advice or had been given inappropriate advice.
Simply denying hormonal methods due to uncertainty is not adequate advice. Contraception and pregnancy should be raised
with all female patients with congenital heart disease. Informed advice is vital to avoid the potential risks of an unplanned pregnancy.
A combined clinic between the cardiologist and family planning doctor offers the optimal informed advice as neither
alone has expertise in the other’s field.
SESSION 4: NEW DEVELOPMENTS IN CONTRACEPTION, SEXUAL AND REPRODUCTIVE
HEALTH
FC4-01
Self-administration of Depot Provera (DMPA) – the way forward?
F. Lakha, A. Glasier
Lothian Primary Care NHS Trust and Department of Obstetrics and Gynaecology, University of Edinburgh, Edinburgh, UK
Introduction: Depo Provera (DMPA) is a popular method of contraception in the UK, but the need to attend for injection
every 12 weeks involves costs to the health service and inconvenience to the user. A micronised preparation of DMPA for
subcutaneous use has been developed and will allow self-administration. In anticipation of subcutaneous DMPA becoming available,
we undertook a survey to determine what percentage of women would want to self-administer the injection and what
would be the most suitable method for reminding women to do it.
Methods: The survey was undertaken in a large family planning clinic in Edinburgh, Scotland. During one calendar month, a
self-administered questionnaire was offered to every woman attending for repeat DMPA injection. A questionnaire was attached
to every packet of DMPA thus ensuring 100% targeting of DMPA users. All data will be entered onto a Microsoft access database
and analysed using SPSS.
Results: 176 women completed the questionnaire, there were no refusals. 118 women (67%) were keen to self-administer
DMPA. 89% of these women felt that they would need a reminder for when to inject. The most popular request was for a
verbal reminder (33%) of the next 3 dates for injection at the time of their annual review; 30% of women preferred to receive a
letter, and 25% a text message, just prior to the date of the next injection. Of the 58 women who did not wish to self-administer
DMPA, the commonest reason was a dislike or fear of needles (62%); 43% were concerned that they would administer the
contraceptive incorrectly; whilst 33% felt it was important to see a doctor every 3 months. Forgetting to self-administer was a
concern to only 12% of women.
Conclusions: Most women are interested in self-administration of DMPA and would like to be informed of future administration
dates at their annual review.
40 The European Journal of Contraception and Reproductive Health Care