Analyse des pratiques concernant la contraception post-IVG médicamenteuse enquête auprès des professionnels de santé réalisant des IVG médicamenteuses en ville dans le cadre du réseau ville-hôpital du CHU de Bordeaux

Abstract : Introduction: the number of medical abortion in the city has been increasing in recent years. In 2017, 53 conventions were signed between city practitioners and the orthogenie department of the Bordeaux University Hospital and undertake to fill out a liaison sheets for each patient applying for abortion. Post-abortion contraception is an important topic. Recommendations have been made and the long-acting reversible contraception (LARC) appear to be more effective in preventing unplanned pregnancies. According to the literature, they are only the second most prescribed means of contraception after the post-abortion pill, and some women are still without contraception.The goal of this study was to analyze the practice of health professionnals of this network regarding their contraceptive prescriptions in post-medical abortion in order to compare this practice with the data of the literature and if necessary, improve the content of liaison sheets. Method: we conducted a quantitative descriptive study based on the analysis of the 2017 liaison sheets, The data collection took place from January 2017 to March 2018. We presented our first results at the AGREGA meeting in April 2018. Results: 1356 liaison sheets, from 35 health professionnals, were exploited. Some practitioners did not return them mentioned the time-consuming nature of this tool. There were 22,4% of liaison sheets without information on prescribed contraception. The pill was the most prescribed method of contraception in after abortion (55,5%) followed by LARC. Only 3,8% of women went out without contraception. Young women were more likely to receive an oestroprogestative pill or implant and older women an intrauterine device or a microprogestative pill. LARC were poorly inserted after medical abortion. Some practitioners of the network expressed reservations to the insertion of these methods. Conclusion: the contraceptive practice of health professionnals in this network seems to be similar to other studies. The discrepancies of recommendations regarding the prescription or insertion of LARC can be explained by the reservations of practitioners about this subject. A qualitative study assessing the determinants of contraceptive practice of network practitioners could be interesting. Finally, a new tool in the form of computer software is to consider in order to facilitate the collection of data.
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Master Thesis
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Angèle Verdon. Analyse des pratiques concernant la contraception post-IVG médicamenteuse enquête auprès des professionnels de santé réalisant des IVG médicamenteuses en ville dans le cadre du réseau ville-hôpital du CHU de Bordeaux. Médecine humaine et pathologie. 2018. ⟨dumas-01970271⟩

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