Postcoital contraception at a tertiary-level hospital emergency department: 3 years’ experience

Clemente Rodríguez C, Puente Palacios I, Puiggalí Ballart M, Laso De La Vega I Artal S, Skaf Peters E, Aranda Cárdenas D

Objective: To describe our experience dispensing postcoital contraceptives (PCCs) in the

emergency department over a 3-year period.

Material and methods: Descriptive study of patients asking for PCCs in the emergency

department between October 2004 and September 2007. We collected data on age,

number of times a PCC was sought, time between requests, contraceptive method used

and the reason for failure, and delay.

Results: We attended 1006 women with a mean (SD) age of 24.3 (6.8) years; 13.4%

were minors and 16.8% were over the age of 30 years. A PCC had been needed

previously by 48.3% of the patients (74% of them once before, 17.8% twice before; and

the remainder, 3 or more times before). The women who needed these agents more

than once were younger (21 [6.5] years vs 24.7 [7.3] years, P=.028). Recurrence within 6

months (143 cases [35.4%]) was also more common among younger women (22.9

[6.5] years vs 24.8 [5.9] years, P=.003). The most common reason for contraceptive

failure was condom breakage (78% of the cases). Delay in seeking a PCC was 12 (19)

hours. In only 2 cases had the 72-hour limit passed. The time elapsed was longer for

women under the age of 18 years (16 [18] hours) and over the age of 30 years (15 [17]

hours) than for women in the intermediate age bracket (12 [19] hours) (P=.009).

Conclusions: Women who seek a PCC in the emergency department are usually young

and have used these agents before. It is important to educate this population that PCCs

are not a contraceptive option for routine use, but rather one to resort to on rare

occasions.

Aranda Cárdenas D, Clemente Rodríguez C, Laso De La Vega I Artal S, Puente Palacios I, Puiggalí Ballart M, Skaf Peters E