Hitna kontracepcija

master's thesis

• Title (english): Emergency contraception
• Author: Ivona Stošić
• Mentor: Marina Šprem Goldštajn (mentor)
• Committee member: Lana Škrgatić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Marina Šprem Goldštajn (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Hitna kontracepcija je jedina metoda kontracepcije koja se može koristiti nakon nezaštićenog spolnog odnosa ili neuspjeha metode redovite kontracepcije. Trenutno dostupne metode hitne kontracepcije, oralna hitna kontracepcija i intrauterini uložak s bakrom, sigurne su metode te se dobro toleriraju. Najčešće korištena metoda hitne kontracepcije je primjena oralnih hitnih kontraceptiva, od kojih su dva režima odobrena u Republici Hrvatskoj: levonorgestrel i ulipristal acetat. Levonorgestrel se treba primijeniti unutar 72 sata od nezaštićenog spolnog odnosa, a ulipristal acetat unutar 120 sati od nezaštićenog odnosa, ali preporuka je primijeniti što prije nakon spolnog odnosa. Oba oralna kontraceptiva su dostupni u slobodnoj prodaji u ljekarnama i izdaju se bez recepta u Republici Hrvatskoj. Mehanizam djelovanja oralnih hitnih kontraceptiva je odgoda ovulacije te ne postoje dokazi da je oralna hitna kontracepcija abortivna, a u slučaju neuspjeha intervencije nema štetnih učinaka na plod ili ishod trudnoće. Oralna hitna kontracepcija se pokazala veoma učinkovitom metodom, ali najučinkovitija metoda hitne kontracepcije je insercija intrauterinog uloška s bakrom. Osim njegove visoke djelotvornosti, prednost intrauterinog uloška s bakrom je mogućnost ostavljanja intrauterinog uloška i kao metodu dugodjelujuće kontracepcije. Primjenom metoda hitne kontracepcije smanjuje se rizik za neželjenom trudnoćom na individualnoj razini, dok javnozdravstveni potencijal hitne kontracepcije još nije ostvaren. Postoje značajne praznine u znanju o hitnoj kontracepciji na razini zdravstvenih djelatnika i samih korisnika. Zablude o hitnoj kontracepciji među zdravstvenim djelatnicima i dalje predstavlja izazove za primjerenu upotrebu hitne kontracepcije. Kako bi se maksimizirao javnozdravstveni potencijal hitne kontracepcije, potrebna je sveobuhvatna edukacija zdravstvenih djelatnika i pacijenata.

Abstract (english)

Emergency contraception is the only method of contraception that can be used after unprotected sex or the failure of a regular contraceptive method. Currently available methods of emergency contraception, oral emergency contraception and intrauterine device with copper are safe methods and are well tolerated. The most commonly used method of emergency contraception is the use of oral emergency contraceptives, of which two regimens are approved in the Republic of Croatia: levonorgestrel and ulipristal acetate. Levonorgestrel should be used within 72 hours of unprotected sex and ulipristal acetate within 120 hours of unprotected sex, but it is recommended that it be used as soon as possible after sexual intercourse. Both oral contraceptives are available over-the-counter in pharmacies and are available without a prescription in the Republic of Croatia. The mechanism of action of oral emergency contraceptives is delayed ovulation, there is no evidence that oral emergency contraception is abortive, and in case of failure of the intervention, there are no adverse effects on the fetus or pregnancy outcome. Oral emergency contraception has proven to be a very effective method, but the most effective method of emergency contraception is the insertion of a copper intrauterine device. Apart from its high efficiency, the advantage of an intrauterine device with copper is the possibility of leaving the intrauterine device as a method of long-therm contraception. The use of emergency contraception reduces the risk of unwanted pregnancies at the individual level, while the public health potential of emergency contraception has not yet been realized. There are significant gaps in knowledge at the level of healthcare professionals and users themselves. Misconceptions about emergency contraception among healthcare professionals continue to pose challenges for the appropriate use of emergency contraception. In order to maximize the public health potential of emergency contraception, comprehensive education of health professionals and patients is needed.

• Keywords: hitna kontracepcija; neželjena trudnoća; levonorgestrel; ulipristal acetat; intrauterini uložak s bakrom
• Keywords (english): emergency contraception; unwanted pregnancy; levonorgestrel; ulipristal acetate; copper IUD
• Language: croatian
• URN:NBN: urn:nbn:hr:105:983230
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-02-24 13:33:47