Quinacrine Sterilization Method Found Effective Among Women in Vietnam

Abstract

The authors of the study posit that quinacrine sterilization has many advantages over surgical sterilization. The study researchers find that quinacrine appears to be safe effective and easy to deliver and is useful to women desiring an end to pregnancy in developing countries. In Vietnam quinacrine use is estimated to have reduced maternal mortality at the rate of 242 deaths prevented as a result of 31781 sterilizations at the low cost of about $1 for two quinacrine insertions. Quinacrine was inserted in 31781 Vietnamese women who were evaluated during 1989-92. 3% of the sample (818 women) subsequently became pregnant. Pregnancy outcomes included 684 induced abortions 19 ectopic pregnancies 6 spontaneous abortions and 79 live births. There was 1 stillbirth and 29 were still pregnant at the end of the study period. There were no deaths or uterine perforations. 8 had a variety of serious complications that were potentially related to the process. All conceptions that occurred within one month of insertion were aborted by menstrual regulation. One infant who was conceived 2.5 months after quinacrine insertion was anencephalic which may have been due to maternal exposure to agricultural chemicals. All other infants were normal. 508 women were studied for menstrual changes and side effects. Side effects after the first insertion includes vaginal itching headache and lower abdominal pain. After the second insertion 77% had no change in menstrual flow 19% had decreased flows and 4% had increased flows. 50 patients were followed up after a year. Those who received only one dose had twice the failure rate of those who received two doses. Pregnancy rates a year after insertion were 2.6% among 9461 women with two insertions compared to 5.2% among women with one insertion. Among 4010 women in one province each of 88 workers had at least one failure (165 pregnancies). Clinicians who performed over 100 insertions had the lowest failure rates of 5% compared to 17% among those who performed 10 or fewer insertions. It was concluded that research was needed on the effectiveness of insertion as it related to placement in the uterus.