1. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..
تنظیم خانواده

2. ارتقائ کیفیت و کمیت خدمات تنظیم خانواده به منظور بهبود سلامت جامعه
هدف كلي اين برنامه : تأمين سلامت مادران و كودكان و ايجاد هماهنگي بين رشد جمعيت و ابزار و عوامل توسعه اجتماعي، اقتصادي و فرهنگي كشور و نهايتاً برقراري عدالت اجتماعي است
ارتقائ کیفیت و کمیت خدمات تنظیم خانواده به منظور بهبود سلامت جامعه
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

3. روشهاي پيشگيري از بارداري
انواع تقسيم‌بندي:
هورموني - غير هورموني
موقت – دائم
سنتي - مدرن
سنتي: عدم نياز به تجهيزات و امكانات خاص
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

4. اثربخشی آن در جلوگیری از بارداری میزان استمرار استفاده صحیح از آن
موفقیت هر روش پيشگيري از بارداري بستگی دارد به:
اثربخشی آن در جلوگیری از بارداری
میزان استمرار استفاده صحیح از آن
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

5. هيچيك از روش هاي پيشگيري از بارداري موجود از كارائي و اثربخشي صد درصد برخوردار نبوده و روش ايده آلي براي توصيه به كليه زوجين و در همه شرايط وجود ندارد. بلكه لازم است متقاضيان استفاده از پيشگيري از بارداري در جريان فرايند مشاوره ضمن كسب اطلاعات لازم و آشنايي با روش هاي در دسترس، روش مناسب را انتخاب نمايند. روش انتخابي و ايده آل براي هر زوج، روشي است كه متقاضي خود آن را انتخاب كرده و قادر به استفاده صحيح از آن است، به طوري كه روش انتخابي نه تنها از نظر فرد داوطلب، بلكه از نظر پزشكي نيز يك روش مناسب، موثر و مطمئن باشد.
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

6. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

7. آمپولهاي تزريقي روشهای هورمونی آمپولهاي پروژسترونی آمپولهاي ترکیبی
قرصهای خوراکی (OCP=Oral Contraceptive Pill)
قرصهای ترکیبی
(COC=Combined Oral Contraceptive)
قرصهای پروژسترونی (دوران شیردهی)
(POP=Progesterone Only Pill )
آمپولهاي تزريقي
آمپولهاي ترکیبی
آمپولهاي پروژسترونی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

8. قرصهای ترکیبی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

9. National Family Health Survey-2
قرص های ترکیبی:
قرص های یک مرحله ای(Monophasic Pill)
میزان ثابتی هورمون در تمام قرص ها وجود دارد. دوزاژ ترکیبی یکسانی می باشند.
قرص های چند مرحله ای(Multiphasic Pill)
میزان هورمون در قرص ها ی مصرفی در طول یک سیکل متغیر است و به نام های دو مرحله ای و سه مرحله ای شناخته می شوند.
National Family Health Survey-2

10. قرص های ترکیبی یک مرحله ای (Monophasic Pill)
فراورده های ایرانی شامل LD و HD
امروزه استفاده معمول از قرص های ترکیبی به محصولات کم دوزLD محدود می شود.
21 قرص لونورژسترل 0/15 میلی گرم
اتینیل استرادیول 0/03 میلی گرم

11. اثربخشی:98 درصد حاوی استروژن و پروژسترون استروژن: اتینیل استرادیول
پروژسترون: لوونورژسترول
انواع:
قرصهای یک مرحله ای (مونوفازیک LD-)
قرصهای سه مرحله ای (تری فازیک)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

12. قرصهای تری فازیک:
نوعی قرص LD هستند که بر اساس سه مرحله سیکل قاعدگی (فولیکولار، پری اوولاسیون، لوتئال)، مقدار استروژن و پروژسترون آنها متفاوت است:
6 قرص اول (نارنجی) استروژن و پروژسترون کمتر
(لونورژسترول 50 میکروگرم اتینیل استرادیول 30 میکروگرم)
5 قرص دوم (زرد) استروژن و پروژسترون بیشتراز مرحله اول
(لونورژسترول 75میکروگرم اتینیل استرادیول 40میکروگرم)
10 قرص سوم (سفید) استروژن مشابه مرحله اول، پروژسترون بیشتر از مرحله دوم
(لونورژسترول 125میکروگرم اتینیل استرادیول 30 میکروگرم)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

13. مکانیسم اثرقرصهای ترکیبی:
ممانعت از اوولاسیون: اثر بر روی هیپوتالاموس و هیپوفیز و مهار ترشح گردد
تغییر در اندومتر (مهار پروليفراسيون اندومتر) و عدم آمادگی برای لانه گزینی
افزایش غلظت موکوس سرویکس و ممانعت از عبور اسپرم
جلوگیری از لقاح از طریق تاثیر بر حرکات لوله های رحم
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

14. مزایاي قرصهاي ترکیبی اثربخشی بالا برگشت سریع باروری پس از قطع روش
نداشتن محدودیت سنی در استفاده از روش
منظم شدن،کاهش درد و خونریزی قاعدگی (کاهش سندرم پیش از قاعدگی یا PMS) و کم خونی به دنبال قاعدگی ها
احتمال کاهش بروز کیست های تخمدانی
احتمال کاستن از بروز بیماریهای خوش‌خیم پستان
کاهش بروز بیماریهای التهابی لگن (PID)
کاهش بروز سرطانهای رحم وتخمدان
احتمال کاهش بروز اندومتریوز
احتمال کاهش آرتریت روماتویید
افزایش تراکم استخوان ها
کاهش بروز حاملگی خارج از رحم (EP)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

15. معایب قرصهاي ترکیبی : نامناسب بودن برای افراد فراموشکار
نیاز به تهیه بسته جدید در هر دوره قاعدگی
پیشگیری نکردن از بیماریهای منتقله از راه تماس جنسی (STI)
مناسب نبودن برای مادران شیرده در6 ماه اول بعد از زایمان
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

16. عوارض شايع قرصهاي ترکیبی:
نکته:
بروز عوارض شایع معمولا در ماههای اول مصرف، كاهش اكثر آنها 2-3 ماه پس از شروع مصرف قرص
لكه‌بيني و خونریزی بین قاعدگی ها:
ناشی از فراموشی قرص - برطرف شدن پس از 2-3 ماه
با شروع لکه بینی روزی 3 مرتبه بمدت 5 روز استفاده از داروهای ضد التهاب غیر استروئیدی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

17. اقدامات لازم در عوارض شايع قرصهاي ترکیبی
تهوع:
مصرف هنگام خواب یاهمراه باغذا- خوردن مایعات بیشترو سبزی ومیوه تازه
درمان موقت تهوع با ضد تهوع (ویتامین B6 شبی یک قرص در 2-3 ماه اول )
قطع قرص در صورت تهوع شدید و غیرقابل تحمل
سردرد خفيف:
مسکن معمولی
در صورت سردرد شدید و یا سردرد همراه با فشار خون بالا یا علایم عصبی یک طرفه یا اختلالات بینایی: ارجاع به متخصص مربوطه و تغییر روش
حساسيت سينه‌ها:
رعایت توصیه های بهداشتی( استفاده ازپستان بند محکم -مسکن معمولی – کمپرس سرد یا گرم)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

18. نکات مهم:
در صورت شک به حاملگی: با مصرف همزمان قرص باید یلافاصله مصرف آن قطع شود و تا اطمینان از وضعیت از کاندوم استفاده شود
در صورت آمنوره ناشی از قرص: بعد از یک دوره آمنوره بین مصرف دو بسته شروع بسته دوم
درصورت دو دوره آمنوره شروع بسته سوم مشروط بر رد حاملگی با انجام آزمایش B-HCG - در صورت ادامه آمنوره ارجاع به متخصص
استفراغ: 3-2 ساعت بعد از مصرف قرص
یک قرص اضافه (از یک بسته دیگر) و ادامه بقیه قرصها طبق برنامه
در صورت تداوم استفراغ یا اسهال شدید: استفاده همزمان از یک روش کمکی دیگر تا یک هفته پس از پایان بیماری
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

19. عوارض نادر قرصهاي ترکیبی (لزوم ارجاع به متخصص)
تغییرخلق وخو (افسردگي)
لکه های رنگی درپوست صورت (كلوآسما)
بروز سرطان پستان
عوارض پیش سرطانی سرویکس
بروز تومورهای خوش خیم و بدخیم کبدی( آدنوم و کارسینوم کبد)
لخته شدن خون در وریدها( ترومبوز وریدی)، به‌ ویژه درافراد سیگاری ومبتلا به اختلالات انعقادی خون
سکته های قلبی(به‌ ویژه درافراد سیگاری )
سکته مغزی(به‌ ویژه درافراد سیگاری و دارای فشارخون بالا)
افزايش فشارخون به بیش از 160 میلیمتر جیوه روی100 میلیمتر جیوه
احتمال بروز خونریزیهای نامنظم رحمی
آمنوره
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

20. مواردمنع مصرف مطلق قرصهاي ترکیبی:
شك يا اطمينان به وجود بارداري
در فاصله زمانی کمتر از سه هفته پس از زایمان در زنان غیر شیرده
شك به وجود كانسر سينه، ابتلا يا سابقه آن
هربدخیمی مشکوک یا وابسته به استروژن
کارسینوم آندومتر
مصرف سیگار در افراد 35 ساله و بالاتر
خونریزیهای رحمی بدون علت مشخص
بيماري فعال يا مزمن كبد (اختلال کار واضح کبدی و یاهپاتيت ويرال، سابقه یرقان همزمان با مصرف قرص ، آدنوم يا كارسينوم كبد، سيروز کبدی، تومورهای خوش خیم و بدخیم کبدی، شیستوزومیازیس یا فیبروز شدید کبدی)
ابتلای فعلی یا سابقه ترومبوفلبیت وریدهای عمقی ، اختلالات ترومبوآمبولیک و یا شرایط مستعد کننده آنها
بیماری عروق كرونر قلب -آنژین قلبی (هر نوع درد جلوی قلب وپشت استرنوم) سابقه این بیماریها یا شرایط مستعدکننده آنها
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

21. مواردمنع مصرف مطلق قرصهاي ترکیبی:
11. بیماری دريچه‌اي قلب با عوارضی مثل افزایش فشار ریوی ، خطر فیبریلاسیون دهلیزی ،سابقه اندوکاردیت تحت حاد باکتریال و یا مصرف داروهای ضد انعقادی
12. بیماریسيانوتيك قلب
13. فشارخون بالا(100/160 و بالاتر)
14. سكته مغزي
15. دیابت با بیماریهای عروقی –رتینوپاتی-نفروپاتی یا نوروپاتی یا ابتلای بیش از بیست سال به دیابت
16. سردرد راجعه شامل میگرن با علائم عصبی موضعی(کاهش میدان دید چشم بطور مشابه- دیدن خطوط زیکزاگی روشن- احساس سوزن سوزن شدن در یک بازو- یک طرف صورت یا زبان
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

22. مواردمنع مصرف مطلق قرصهاي ترکیبی:
17. میگرن بدون علائم فوکال عصبی و سن بیشتر از 35 سال بیشتر
18. افزایش چربی های خون (دیس لیپدمی بخصوص لیپوپروتیینمی نوع 2)
19. سابقه هر بیماری مرتبط با مصرف قرص مثل کره،فشارخون بالا، پانكراتيت حاد – پمفیگوئید حاملگی – سندرم استیون جانسون = Thrombotic Thrombocytopenic Purpura-Hemolytic Syndrome
20. شرایط نیازمند به بی حرکتی کامل (مثل جراحي - بايد 28 روز قبل از جراحي قرص تا پایان دوره بی حرکتی عمل قطع شود)
21. ابتلا به
Serious trauma,Cancer,Lukemia,Vascular disease(SLE,….)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

23. مواردمنع مصرف نسبي قرصهاي ترکیبی:
مادران شیردهی که از زایمان آنها کمتر از شش ماه می گذرد
میگرن بدون علائم عصبی
دیابت بدون درگیری عروقی
افسردگی خیلی شدید
مصرف دارو برای اپی لپسی (به‌جز والپروییک اسید )
مصرف ریفامپین یا گریزوفولوین
ابتلای به بیماری های التهابی روده مانند کرون یا کولیت زخمی
فشارخون کنترل شده بین90/140تا100/ 160
نئوپلازی داخل اپیتلیومی خفیف تا شدید سرویکس
بیماری فعال کیسه صفرا
سابقه یرقان انسدادی در حاملگی
خانمهای سیگاری کمتر از 35 سال
توده پستانی تشخیص داده نشده
ترومبو فلبیت سطحی
بیماریهای دریچه ای بدون عارضه قلبی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

24. زمان شروع قرصهاي تركيبي:
1- دوران قاعدگی :شروع طي 5روز اول قاعدگي (ترجيحاً از روز اول و در ساعت معین)-ادامه تا 21 روز- قطع به مدت 7 روز (رخ دادن قاعدگي) شروع مجدد پس از 7روز بدون توجه به زمان رخ دادن قاعدگي
2- غیر از دوران قاعدگی :در هر زمان با اطمینان از عدم حاملگی
در 7 روز اول از کاندوم هم استفاده شود.
3- پس از سقط: طی 5 روز اول پس از سقط
4- تغییر از یک روش دیگر:
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

25. آزمایشات در ویزیت اول ضروری نیست
معاینه و آزمایشهای لازم در قرصهاي ترکیبی:
ويزيت اول:
معاینه از نظر زردی – اندازه گیری فشارخون
اندازه گیری قد و وزن(BMI)- معاینه سینه
BMI بیش از 30 ویزیت پزشک قبل از تحویل قرص
آزمایش پاپ اسمیر(6-4 هفته پس از زایمان)
بررسی مشکلات انعقادی و ليپيدهاي خون (درصورت سابقه ترومبوز ویا بیماریهای قلبی در بستگان درجه یک زیر 50سال)
اندازه گیری تری گلیسرید:(بیش از 250میلی گرم در 100 میلی لیتر آزمایش مجدد4-2 هفته بعد وبیش از 500 میلی گرم در 100 میلی لیتر قطع قرص به دلیل احتمال پانکراتیت)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..
آزمایشات در ویزیت اول ضروری نیست

26. معاینه و آزمایشهای لازم در قرصهاي ترکیبی:
ويزيتهاي بعدي (پیگیری):
اولین بررسی درعرض سه ماه و سپس هر6 ماه یکبار تا دو سال، ازآن پس درصورت نبود مشکل هرسال
بررسي از نظر:
فشارخون- وزن (BMI )- پیگیری بروز علائم هشدار و عارضه ها - بررسی دقیق خانم های دارای بیماری مزمنی که اثرقرص روی آن بیماری مشخص نیست (مثل گواتر)
درصورت وجود مشکل، ارجاع به متخصص مربوطه
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

27. بررسی سالانه قند – چربی- لیپوپروتئین بطور روتین در:
خانم های 35 ساله و بالاتر
خانم های با سابقه بیماری قلبی یا فشارخون بالا
دیابتی ها
خانم های با سابقه دیابت حاملگی
خانم های با نمایه توده بدنی بيشتر ار 30
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..
ارجاع به سطوح بالاتر

28. در صورت فراموش كردن مصرف قرص ترکیبی
LD و تری فازیک :
1-يک قرص و به یاد آوردن تا زمان مصرف قرص بعدی:
-مصرف قرص فراموش شده به محض به یاد آوردن
ادامه مصرف قرصها طبق برنامه
2- دو قرص مصرف دو قرص فراموش شده در دو شب متوالي
-ادامه مصرف قرصها و استفاده از كاندوم تا يك هفته
3- بیش از دو قرص ادامه مصرف بقيه قرصها (روزي يك عدد)
- استفاده از روش كمكي ديگر تا يك هفته
شروع بسته بعدي بلافاصله پس از اتمام بسته فعلي (بدون فاصله هفت روزه)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

29. درد قفسه سینه یا تنگی نفس یا سرفه با خلط خونی
هشدار: ارجاع فوری به محض بروز علایم ذیل در حین مصرف قرصهاي ترکیبی
درد شدید بالای شکم
درد قفسه سینه یا تنگی نفس یا سرفه با خلط خونی
تورم یا درد شدید در یک پا
مشکلات چشمی (از دست دادن یک طرفه قدرت بینایی یا کم شدن میدان دید)
سردرد غیر معمول (شدید، ضربانی، یک طرفه)
سردرد با علائم اولیه (تاری دید ،از دست دادن قدرت بینایی دوره ای ،احساس سنگینی و پارستزی ، سختی در صحبت کردن و ضعف یک طرفه)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

30. آمپول هاي ترکیبی پیشگیری از بارداری
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

31. آمپول هاي ترکیبی پیشگیری از بارداری
آمپول سیکلوفم (LUNELLE)
تركيبي از استروژن و پروژسترون
5 ميليگرم استراديول سيپيونات (estradiol cypionate ) و 25 ميليگرم دپومدروكسي پروژسترون استات (MPA)
اثر بخشی 99.8% در سال اول استفاده
مكانيسم عمل:
جلوگیری از تخمک گذاری
دشوار نمودن رسیدن اسپرم به رحم از طریق افزایش غلظت ترشحات دهانه رحم
تاثیر بر مخاط داخلی رحم ( مهار پروليفراسيون اندومتر)
جزء MPA باعث مهار تخمك گذاري و جزء استروژن باعث ايجاد الگوي خون ريزي مشابه با زناني است كه از روش هاي هورموني استفاده نمي كنند .
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

32. مزاياي آمپول هاي ترکیبی
مزاياي شبيه قرصهای ترکیبی:
اثربخشی بالا
استفاده آسان و آسانی قطع استفاده
برگشت نسبتاً سریع باروری پس از قطع
کاهش خونریزی قاعدگی- بهبود دیسمنوره
مناسب براي افراد با سابقه حاملگي خارج رحمي (EP)
بی تاثیر بودن روی میل جنسی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

33. ادامه مزاياي آمپول هاي ترکیبی
مزاياي قابل مقايسه با قرصهای ترکیبی :
مناسب براي افرادي كه با استفاده هر روزه يك روش مشكل دارند (فراموشكار، كوچ‌نشين، عقب‌مانده‌ ذهني)
كم بودن عوارض ناشي از استروژن
كم بودن عوارض افزايش وزن و خونريزي نامنظم
كم نشدن اثربخشي در موارد اسهال و استفراغ
تأثير كم بر سيستم انعقادي
قابل استفاده همزمان با آنتی بیوتیک ها(بجز ریفامپین و گریزوفولوین)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

34. معايب آمپول هاي ترکیبی عدم پيشگيري از STI
عدم امكان قطع روش يا تغيير آن پس از تزريق آمپول تا از بين رفتن اثر آن (اتمام دوره)
مناسب نبودن براي دوران شيردهي تا شش ماهگی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

35. عوارض شايع آمپول هاي ترکیبی :
سردرد و سرگیجه -افزايش وزن خفیف- حساسيت سينه‌ها
آکنه- افزایش بروز افسردگی و اضطراب -
کاهش HDL و کم شدن HDL بهLDL
کم شدن مقدار و تعداد روزهای خونریزی قاعدگی
عوارض ناشایع: آمنوره – خونریزی نامنظم رحمی
نکته:
بروز عوارض شایع معمولا در ماههای اول مصرف، كاهش یا از بین رفتن علائم 2-3 ماه پس از شروع
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

36. موارد منع مصرف آمپول هاي ترکیبی
مطلق:
شبيه قرصهای ترکیبی
نسبي:
(به استثنای ابتلا به بیماری های التهابی روده)
(به اضافه: بیماری سلول داسی شکل)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

37. درد قفسه سینه یا تنگی نفس یا سرفه با خلط خونی
ارجاع فوری به محض بروز علایم ذیل در حین مصرف آمپول هاي ترکیبی
درد شدید بالای شکم
درد قفسه سینه یا تنگی نفس یا سرفه با خلط خونی
تورم یا درد شدید در یک پا
مشکلات چشمی (از دست دادن یک طرفه قدرت بینایی یا کم شدن میدان دید)
سردرد غیر معمول (شدید، ضربانی، یک طرفه)
سردرد با علائم اولیه (تاری دید ،از دست دادن قدرت بینایی دوره ای ،احساس سنگینی و پارستزی ، سختی در صحبت کردن و ضعف یک طرفه)
زردی اسکلرا و پوست
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

38. آزمايشها و معاينات لازم:شبيه قرصهای ترکیبی چگونگي مصرف:
تزریق هر ماه (3 روز زودتر يا ديرتر)
تزريق عضلانی (بالای عضله بازو يا باسن) و عميق (با سر سوزن بلند) بدون ماساژ دادن محل تزريق
هماهنگی دمای ویال با دمای بدن
برگشت باروري:
2-3 ماه پس از آخرین تزریق
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

39. قرص پروژستروني قرص پروژستروني دوران شيردهي (لاينسترول) اثر بخشی:
مصرف فقط مادران شیرده تا 6 ماه پس از زایمان
بدون اثر بر میزان شیر
مصرف روزانه، راس ساعت معین
ارائه توسط كاركنان بهداشتی دوره ديده.
اثر بخشی:
در صورت مصرف صحیح در دوران شیردهی، 99% است.
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

40. مكانيسم عمل قرص پروژستروني
دشوار نمودن رسیدن اسپرم به رحم از طریق افزایش غلظت ترشحات دهانه رحم
جلوگیری از تخمک گذاری (در نیمی از موارد)
تأثیر بر مخاط داخلی رحم (آندومتر)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

41. مزایای قرص پروژستروني نداشتن اثر منفی بر کمیت و کیفیت شیر مادر
افزایش مدت زمان شیردهی
قابل استفاده در مادران شیرده با فرزند کوچکتر از 6 ماه
عدم نیاز به قطع روش قبل از عمل جراحی
نداشتن فاصله 7 روزه بین بسته ها و کاهش احتمال مصرف نادرست
بازگشت باروری بلافاصله پس از قطع قرص
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

42. معایب قرص پروژستروني نياز به مصرف روزانه، راس ساعت معین
در غیر این صورت:
احتمال افزایش شکست روش (به ویژه در مادران شیردهی که قاعدگی آنها باز گشته است)
نامنظم شدن قاعدگی ها
تاثیر کمتر در پیشگیری از بارداری خارج رحمی نسبت به داخل رحمی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

43. عارضه شايع قرص پروژستروني
خونریزی نا مرتب رحمی
معمولاً در ماه های اول مصرف پس از 2 تا 3 ماه از بین رفته یا کاهش می‌یابد.
در صورت تداوم خونریزی نامرتب و یا نارضایتی فرد، برای قطع خونریزی، کپسول مفنامیک اسید (250 میلی گرمی) روزی سه بار (در هر بار دو عدد) تا 5 روز
در صورت تداوم خونریزی علیرغم درمان پس از 3 ماه، فرد به متخصص زنان ارجاع داده شود
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

44. عوارض غيرشايع قرص پروژستروني (ارجاع به متخصص)
عوارض غيرشايع قرص پروژستروني (ارجاع به متخصص)
كيست های تخمدانی
حاملگی خارج از رحم (EP)
خونريزی شديد
سردردهاي شديد (ميگرن، سردرد های همراه با تاری ديد) و يا سردرد های طولانی مدت و مزاحم
حساس شدن پستان
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

45. موارد منع مصرف مطلق قرص پروژستروني
سابقه و ابتلا به سرطان پستان
خونریزی غیر طبیعی رحم
اختلالات مزمن يا حاد كبدی (تومور، هپاتيت و غيره)
ابتلای فعلی به ترومبوز وریدهای عمقی - آمبولی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

46. موارد منع مصرف نسبي قرص پروژستروني
وزن بیش از 70 کیلوگرم
سابقه كلستاز بارداری
فشار خون بالا ( 100/160 ميلي متر جيوه و بالاتر)
مصرف هم زمان داروهای ضد اپی لپسی و ريفامپين واحتمالا گریزوفولوین(در صورت اجبار 2 قرص روزانه)
سابقه EP
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

47. زمان شروع استفاده از قرص پروژستروني:
مادران شيرده:
1) عدم قاعدگی - تغذيه انحصاری شيرخوار با شير مادر: 6 هفته پس از زايمان
2) بازگشت قاعدگي - تغذيه انحصاری با شير مادر:
شروع مصرف قرص در يكی از پنج روز اول قاعدگي و ترجیحاً روز اول
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

48. چگونگی استفاده از قرص پروژستروني:
هر بسته 28 قرص دارد كه هر شب یکی راس ساعت معین ميل مي‌شود
شروع مصرف بسته بعدی: بلا فاصله پس از پایان بسته قبلی
دقت شود: بین دو بسته قرص هیچ فاصله زمانی نباید وجود داشته باشد
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

49. فراموشي قرص پروژستروني
فراموشی یک قرص:
تا 3 ساعت مساله ای نیست
بیش از 3 ساعت:
خوردن قرص فراموش شده به محض يادآمدن و مصرف قرص بعدی در ساعت همیشگی همراه با استفاده از روش کمکی تا 2 روز
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

50. فراموشي قرص پروژستروني
فراموشي دو قرص (2 روز متوالی):
خوردن قرصها يكجا به محض يادآمدن
ادامه بقيه قرصها در ساعت مقرر
استفاده از روش کمکی تا 7 روز
و در صورت قاعده نشدن در مدت 6-4 هفته پس از فراموشی ، بررسی بارداری لازم است
در صورت داشتن نزديكی محافظت نشده در دو روز گذشته، استفاده از EC (پیشگیری اورژانس( و پس از 3 هفته بررسی بارداری
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

51. فراموشی سه قرص متوالی و بیشتر پروژستروني
و داشتن نزدیکی محافظت نشده در عرض 120 ساعت اخیر:
تجویز EC و مشاوره برای انتخاب یک روش مناسب دیگر
در صورت گذشت بیش از 120 ساعت از نزدیکی محافظت نشده:
بررسی بارداری با آزمایش B-HCG
استفاده از کاندوم تا مشخص شدن جواب
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

52. معاينات لازم در مصرف قرص پروژستروني
اندازه گیری وزن
اندازه گیری و ثبت فشار خون
پاپ اسمير
معاینه لازم در صورت وجود هرگونه نکته خاص در شرح حال
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

53. سردرد شدید(میگرن-سردردهای همراه با تاری دید)
هشدارها (در صورت بروز علایم زیر، مراجعه فوری به بیمارستان یا متخصص مربوطه)
خونریزی نامرتب رحمی (یا هرخونریزی بدون دلیلی که احتمال بیماری زمینه ای و یا حاملگی را مطرح نماید)
سردرد شدید(میگرن-سردردهای همراه با تاری دید)
درد شدید قفسه سینه بعد از شروع لاینسترول
زردی چشم یا پوست
درد شدید شکمی بخصوص در قسمت پایین شکم و لگن( احتمال EP و پارگی کیست تخمدان)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

54. National Family Health Survey-2

55. DMPA (مگسترون) (Depo Medroxy Progesterone Acetate)
اثر سه ماهه
اثر بخشی بیش از 99.7% در سال اول استفاده
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

56. DMPA (مگسترون) مكانيسم عمل: جلوگیری از تخمک گذاری
دشوار نمودن رسیدن اسپرم به رحم از طریق افزایش غلظت ترشحات دهانه رحم
تاثیر بر مخاط داخلی رحم ( مهار پروليفراسيون اندومتر)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

57. مزاياي DMPA اثر بخشی بالا
آسانی استفاده (فاصله های استفاده نسبتا طولانی مدت)
مناسب براي افرادي كه با استفاده هر روزه از يك روش مشكل دارند (فراموشكار، كوچ‌نشين، عقب‌مانده‌ ذهني)
کاهش ابتلا به:
سرطان های آندومتر و تخمدان، بيماري التهابي لگن(PID)، کم خونی، فیبروم رحم، اندومتریوز، حاملگي نابجا(EP)، کاندیدیازیس واژن، سندرم قبل از قاعدگي(PMS)، درد زمان قاعدگی و درد حين تخمك‌گذاري (میتل اشمرز)
مناسب برای بیماران دیابتی و تیروییدی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

58. قابل استفاده از سن 16 سالگی قابل استفاده در شيردهي و افزایش شیر مادر
مزاياي DMPA(ادامه)
قابل استفاده از سن 16 سالگی
قابل استفاده در شيردهي و افزایش شیر مادر
تداخل نداشتن باتماس جنسی
عدم نیاز به قطع مصرف قبل از اعمال بزرگ جراحی
مناسب برای بیماران تشنجی (به شرط عدم مصرف همزمان با کاربامازپین و فنی تویین)
نداشتن عوارض استروژنی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

59. تاخير در بازگشت باروری (8-9 ماه پس از تزريق آخر) تزريقی بودن
معايب DMPA
تاخير در بازگشت باروری (8-9 ماه پس از تزريق آخر)
تزريقی بودن
عدم پيشگيری از STI مانند ايدز و ...
احتمال افزايش وزن
اختلالات خونریزی قاعدگی: آمنوره- لکه بینی و خونریزی نامرتب
احتمال بروز تغییرات خلقی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

60. عوارض شايع DMPA اختلالات قاعدگی (لکه بینی- آمنوره و خونریزی نامرتب)
-خونریزی: در 2-3 ماه اول و سپس بهبود
استفاده از مفنامیک اسید و قرص آهن
-آمنوره: (اگر از ابتدای تزریق DMPA باشد، باید به فرد اطمینان داده شود)
(اگر پس از تزریق، قاعدگی منظم داشته و اخیراً آمنوره رخ داده: بررسی بارداری لازم است)
2- افزایش وزن
3- حساس شدن پستان ها
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

61. تغییر خلق (بی خوابی و افسردگی) سردرد و گیجی نفخ شکم کاهش میل جنسی
عوارض غير شايع DMPA
تغییر خلق (بی خوابی و افسردگی)
سردرد و گیجی
نفخ شکم
کاهش میل جنسی
تاخیر در بازگشت باروری
شک به وجود سرطان پستان
حساسیت
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

62. موارد منع مصرف مطلق DMPA
بارداری
سرطان پستان
خونریزی واژینال بدون علت مشخص
اختلالات شدید انعقادی
سابقه تومور(آدنوم) کبدی ناشی از مصرف هورمونهای استرویید جنسی
ترومبوآمبولی فعلی
سابقه سکته مغزی
فشار خون کنترل نشده
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

63. موارد منع مصرف نسبی DMPA
بیماری کبدی
سابقه و بیماری فعلی قلبی- عروقی شدید
تمایل به برگشت سریع باروری
مشکلات مرتبط با تزریق (ترس، ...)
افسردگی شدید
فشار خون کنترل شده
دیابت با ضایعه عروقی و یا ابتلا به دیابت به مدت 20 سال یا بیشتر
سابقه مول
چاقی) نمایه توده بدنی بیش از 30)
سن کمتر از 16 سال
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

64. زمان شروع استفاده از DMPA :
اولين دوره: دريكي از پنج روز اول قاعدگی
و تا يك هفته استفاده از کاندوم
پس از زايمان :
عدم شیردهی: 3 هفته بعد (بدون نياز به برگشت قاعدگی)
مادر شیرده:
قاعده نشدن و تغذيه انحصاری: 6هفته پس از زايمان
قاعده شدن و تغذيه انحصاری: پنج روز اول قاعدگی (تا يك هفته نيز روش كمكی)
پس از سقط :
در 5 روز اول
(پس از 5 روز منوط به پاسخ منفی تست بارداری B-HCG و رعايت ساير شرايط)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

65. چگونگی استفاده از DMPA :
تزریق هر سه ماه (تا 2هفته زودتر يا ديرتر اشکالی ندارد)
بدليل اينكه بعد از يك تزريق، حداقل تا 14 هفته بعدتخمك گذاري اتفاق نمي افتد، زنان براي تزريق بعدي دو هفته فرصت خواهند داشت، علي رغم آن توصيه مي شود در صورتي كه زنان براي تزريق بعدي بيشتر از 13 هفته بعد مراجعه كنند لازم است از عدم حاملگي اطمينان حاصل شود . تكان دادن شديد آمپول يا ويال برای ايجاد سوسپانسيون يكنواخت
تزريق عضلانی (بالای عضله بازو يا باسن) و عميق (با سر سوزن بلند) بدون ماساژ دادن محل تزريق
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

66. آزمایش ها و معاینه های لازم:
اندازه گیری و ثبت وزن
اندازه گیری و ثبت فشار خون (با توجه به منع نسبی بودن فشار خون تحت کنترل)
اندازه گیری لیپو پروفایل
(اگر LDL بالای 200 و دو ریسک فاکتور بیماری قلبی و یا اختلالات نادر لیپیدی وجود داشته باشد، آغاز استفاده از DMPA توصیه نمی شود)
پاپ اسمير
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

67. هشدارها (در صورت بروز علایم زیر، مراجعه فوری به بیمارستان)
خونریزی شدیدارجاع فوری
افزایش فشار خون (در حدی که نیازمند درمان باشد) ارجاع فوری
سردرد شدید همراه با تاری دیدارجاع فوری
زردی چشم یا پوستارجاع فوری
تأخیر قاعدگی (در فردی که حین استفاده از DMPA ، قاعدگی منظم داشته است)
خونریزی طولانی (دو برابر شدن مقدار یا مدت قاعدگی در مقایسه با قبل)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

68. استفاده از DMPA پیش از زایمان اول؟؟ امکان تاخیر در بازگشت باروری
توصیه به مصرف نشدن در افراد زیر 16 سال (با توجه به احتمال اثر منفی بر رشد استخوانی)
حاملگی هم زمان با استفاده از DMPA
احتمال افزایش مرگ و میر نوزادی و نئوناتال (کاهش وزن هنگام تولد-IUGR)
نیاز به مراقبت ویژه و ارجاع به متخصص زنان
در صورت عدم تمایل به ادامه استفاده از DMPA و نیز عدم تمایل به بارداری، علیرغم تأخیر در بازگشت باروری پس از پایان مهلت 3 ماهه، باید از یک روش دیگر استفاده شود
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

69. National Family Health Survey-2
Dr Seyyed Alireza Moravveji Community Medicine Specialist 69
National Family Health Survey-2

70. Intra Uterine Device (IUD) Condom
روشهای غير هورمونی
موقت:
Intra Uterine Device (IUD)
Condom
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

71. پیشگیری از انتقال بیماریهای قابل انتقال از تماس جنسی (STI)
Condom
ساخته شده از لاتکس
پیشگیری از انتقال بیماریهای قابل انتقال از تماس جنسی (STI)
مکانیسم عمل:
جلوگیری از رسیدن اسپرم به تخمک
اثر بخشی :
حدود 97 درصد با استفاده صحیح
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

72. مزاياي كاندوم
جلوگیری از انتقال بیماریهای منتقله از راه تماس جنسی(STI/AIDS)
کاهش خطر بروز سرطان دهانه رحم
قابل استفاده در هر گروه سنی
کمک به جلوگیری از انزال زودرس
آسانی استفاده و نداشتن عوارض موضعی و عمومی
نداشتن آثار هورمونی
قابل استفاده بلافاصله پس از زایمان
نداشتن اثر بر شیردهی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

73. معايب كاندوم ایجاد حساسیت به کاندوم( در بعضی) لزوم استفاده پس از نعوظ
احتمال خارج شدن یا پاره شدن آن
موارد منع مصرف کاندوم
حساسیت به لاتکس و بروز خارش و یا لکه های پوستی در زوجین
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

74. نکات قابل توجه استفاده از یک کاندوم جدید در هر تماس
مشاهده و اطمینان از سالم بودن کاندوم پیش از مصرف آن
لزوم استفاده در حالت نعوظ و قبل از تماس
لزوم خروج کاندوم بلافاصله پس از انزال
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

75. توجه حین استفاده از کاندوم به سوراخ نشدن آن با ناخن، ا نگشت یا انگشتر.
عدم استفاده از لوبریکانتها بدلیل افزایش احتمال آسیب به کاندوم و پاره شدن آن.
توجه حین استفاده از کاندوم به سوراخ نشدن آن با ناخن، ا نگشت یا انگشتر.
استفاده نکردن از کاندومهای شکننده، تاریخ گذشته، تغییر شکل يا تغییر رنگ یافته و یا کاندوم با بسته بندی دروني صدمه دیده
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

76. تحویل قرصهای روش اورژا نس پیشگیری از بارداری (EC) به متقاضی
شرايط نگهداري:
در جای خنک و تاریک
دور از آفتاب، گرما، رطوبت، نور لامپ فلوئورسانس و اشعه ماورای بنفش
تحویل قرصهای روش اورژا نس پیشگیری از بارداری (EC) به متقاضی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

77. National Family Health Survey-2

78. IUD از جنس فلز يا پلاستيك کارگذاری در داخل رحم تاريخچه:
در طول تاريخ توسط شتربانها براي جلوگيري از بارداري شترها در هنگام عبور از صحرا
از 300 سال پيش در دنيا استفاده مي‌شود
اثر بخشی حدود 99/8 درصد
ارائه توسط پزشک، ماما و یا کارکنان بهداشتی آموزش دیده
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

79. انواع IUD نسل اول (خنثي): فاقد ماده مؤثر خاص
از جنس پلي‌اتيلن آغشته به سولفات باريم (جهت رویت در رادیوگرافی)
نام ديگر: non medicated
نسل دوم (مسي )
ا Copper T380A :
از جنس پلي اتيلن، حاوي 380 mm2 مس و به شكل T
تا ده سال پیشگیری از بارداری
اثر بیشتر و عوارض كمتر نسبت به نسل اول
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

80. انواع IUD نسل سوم (پروژستروني):
آزاد كننده هورمون به داخل رحم (اثر موضعي – عدم اثر بر محور هيپوتاموس-هيپوفيز-تخمدان)
خونريزي و طول دوره قاعدگي كمتر نسبت به انواع مسي
قيمت بالا، مؤثرتر از ساير انواع
دو نوع: Progestasert و LNG-IUD
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

81. مکانیسم عمل IUD ناشناخته
ایجاد التهاب در حفره رحم و صدمه به اسپرم (كاهش قابليت حيات و تحرك آن)
اختلال (افزايش) در حرکات لوله های رحمی و جلوگیری از انتقال اسپرم و رسیدن آن به تخمک
تغییر در سرویکال موکوس و ترشحات آندومتر
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

82. مزایاي IUD اثربخشی بالا برگشت باروری بلافاصله پس از خروج
مدت اثر طولانی
نیاز نداشتن به یادآوری روزانه
عدم تاثیر بر شیردهی
نداشتن آثار و عوارض هورمونی
قابل استفاده تا دوران منوپوز
عدم تداخل با تماس جنسی
تداخل نداشتن با مصرف داروها
احتمال کاهش شیوع سرطان آندومتر و تخمدان
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

83. معايب IUD امکان خروج خود به خود
عدم پیشگیری از انتقال بیماریهای منتقله از راه تماس جنسی
لزوم معاینه دوره‌ای
لزوم کارگذاری و خروج توسط فرد دوره دیده
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

84. عوارض شایع IUD افزایش خونریزی و درد زمان قاعدگی
خونریزی نامنظم و لکه بینی بین قاعدگی ها
افزایش ترشحات واژينال
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

85. بيماريهاي التهابي لگن (PID):
عوارض غير شایع IUD
بيماريهاي التهابي لگن (PID):
در 20 روز اول جايگذاري
به خاطر عدم تشخيص عفونت موجود از قبل يا عدم رعايت استريليتي
سوراخ شدن رحم هنگام جايگذاري
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

86. موارد منع مصرف مطلق IUD حاملگی یا شک به آن
سابقه PID منجر به بستری در بیمارستان
آنومالی رحم
Wilson يا حساسيت به مس (در IUD هاي مس دار)
نقص سیستم ایمنی
شک به وجود بدخیمی رحم یا سرویکس و یا قطعیت آن
فیبروم همراه با تغيير شکل غیر طبیعی رحم
خونریزی شدید قاعدگی (دفع لخته) یا آنمی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

87. خونریزی واژینال تشخیص داده نشده اختلال انعقادی
موارد منع مصرف مطلق IUD
خونریزی واژینال تشخیص داده نشده
اختلال انعقادی
درفاصله زمانی بين درمان و پيگيري مول(حداقل يك سال)
سل لگنی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

88. موارد منع مصرف نسبي IUD سابقه PID بدون بستری در بیمارستان
Multiple Partner
سابقه منوراژی
سابقه دیسمنوره
سابقه یا ابتلای اخیر به STI
اندومتریت پس از زایمان یا سقط عفونی در سه ماهه گذشته
نداشتن سابقه زایمان
سرویسیت و واژینیت درمان نشده
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

89. زمان شروع استفاده از IUD
طي پنج روز اول قاعدگی
6هفته پس از زایمان یا سزارین
سقط:
زیر 12 هفته بشرط عفونی نبودن: طي پنج روز اول
بالای 12 هفته: 6 هفته بعد
مادران شیردهی که قاعدگی آنها برنگشته است:
6 هفته پس از زایمان با اطمینان از عدم بارداری
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

90. آزمایش ها و معاینه های لازم در IUD
اولين مراجعه:
معاینه رحم (بررسی موقعیت و عفونت)
اندازه گیری هموگلوبین خون
بررسی موارد کنتراندیکاسیون مطلق و نسبی
مراجعات بعدي:
اولین بررسی پس از اولین قاعدگی (براي ديدن نخ IUD)
بررسیهای بعدی هر شش ماهه در زمان غیر قاعدگی
معاینه لگنی (بررسی موقعیت رحم و عفونت)
پاپ اسمیر
اندازه گیری هموگلوبین خون در صورت (رنگ پریدگی ناخن ها-گیجی- ضعف-خستگی-سردرد-زخم زبان –احساس صدای زنگ در گوش- سر درد- تحریک پذیری)
بررسی وضعیت رضایتمندی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

91. در صورت رخ دادن بارداري همراه با IUD
بارداري داخل رحمي:
نيمه اول بارداري و
ديده شدن نخ IUD: خارج كردن نخ
عدم ديده شدن نخ IUD: ارجاع
نيمه دوم بارداري: ارجاع
بارداري خارج رحمي: ارجاع
نکته: در صورت ادامه بارداری، IUD باعث ناهنجاری جنین نمی شود.
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

92. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

93. موارد استفاده ECظرف 120 ساعت گذشته:
استفاده نکردن از کنتراسپتیوها
تجاوز
استفاده نادرست یا شکست کنتراسپتیوهمراه با داشتن تماس جنسی مانند:
پارگی یا خارج شدن کاندوم
فراموشی خوردن قرص ترکیبی برای سه نوبت پیاپی
فراموشی خوردن قرص شیردهی به مدت بیش از 3 ساعت
تاخیر بیش از 2 هفته در تزریق آمپول DMPA
تاخیر بیش از 3 روز در تزریق آمپول های ترکیبی
استفاده نادرست از روش طبیعی یا منقطع با شک تماس جنسی منجر به بارداری
خروج IUD
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

94. زمان شروع و چگونگي مصرف EC
در 120 ساعت اول پس از تماس مشکوک:
2قرص لوونورجسترول يكجا
4قرص LD يكجا و 4 عدد 12 ساعت بعد
4 قرص تريفازيك سفيد (قرصهاي مرحله سوم) يكجا و 4 عدد 12 ساعت بعد
حداكثر دفعات مجاز در هر سيكل قاعدگي: 1 دفعه
در صورت استفراغ تا 2 ساعت پس از مصرف: لزوم مصرف مجدد- با شکم خالی مصرف نشود
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

95. مكانيسم عمل روش پيشگيري اورژانس از بارداری :
ناشناخته
جلوگیری از تخمک گذاری
تاخیر در تخمک گذاری
اختلال در اندومتر
اختلال در نفوذ اسپرم
اختلال در حركت لوله‌هاي رحمي
اختلال در لقاح - ویا مجموعه ای از عوامل
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

96. روش پيشگيري اورژانس از بارداری
اثربخشي:
99-97 درصد كه بستگي به فاصله زمانی تماس جنسی تا آغاز استفاده از روش دارد مصرف به موقع دارد
اثربخشی با قرص های لوونورجسترول حدود 99 درصد
اثربخشی با قرص های ترکیبی حدود 97 درصد
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

97. عوارض روش پيشگيري اورژانس از بارداری
تهوع و استفراغ:
با قرص های ترکیبی به ترتیب50%و20%
با قرص لوونورجسترول20%و 6%
پیشگیری: قرص ديمن‌هيدرينات میلی گرم 4-3 در روزيا قرص(شربت) ديفن‌هيدرامين، قبل و 4-6 ساعت پس از مصرف هر دوز
اختلال قاعدگي:
چند روز زودتر يا ديرتر شروع مي‌شود- تغییر در مقدار و میزان - بي‌خطر است
سردرد و سرگیجه
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

98. منع مصرف EC قرص ترکیبی بارداری ( به دلیل بی اثر بودن نه خطر برای جنین)
موارى منع استروژن- ميگرن كلاسيك- ترمبوز وریدهای عمقي
قرص لوونورجسترول
پوروفیری حاد
بیماری شدید و فعال کبد در حال حاضر
خونریزی های غیر طبیعی تشخیص داده نشده تناسلی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

99. در صورت تاخیر قاعدگی بیش از 7 روز بررسی از نظر بارداری
در صورت مصرف فنی توئین و ریفامپین بدلیل کاهش اثربخشی روش قرص لوونورجسترول
در صورت تاخیر قاعدگی بیش از 7 روز
بررسی از نظر بارداری
با توجه به تراتوژن نبودن روش برای جنین در صورت حاملگی هم زمان با روش
نیازی به ختم حاملگی نمی باشد
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

100. National Family Health Survey-2
100

101. روشهای غير هورمونی موقت: دائمي: Intra Uterine Device (IUD) Condom
Tubectomy (TL: Tubal Ligation)
Vasectomy
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

102. TL یک عمل جراحی ساده و کم خطر
لوله های رحمی متقاضی طی بیهوشی عمومی ( یا بی‌حسی موضعی ) بسته می‌شود
توسط متخصص زنان، به صورت سرپایی ( و یا بستری با یک روز اقامت ) در بیمارستان
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

103. مکانیسم عمل : اثر بخشی: بیش از 99 درصد
با بسته شدن لوله های رحمی(حد فاصل رحم و تخمدانها) ازرسیدن اسپرم و تخمک به یکدیگر و تشکیل سلول تخم جلوگیری بعمل می‌آید.
اثر بخشی:
بیش از 99 درصد
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

104. مزاياي TL دایمی بودن اثر بخشی بالا عدم نیاز به یاد آوری و مراجعه مکرر
نداشتن عارضه برای سلامتی فرد استفاده کننده در دراز مدت
کاهش ابتلا به سرطان تخمدان
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

105. معايب TL نیاز به عمل جراحی
پر هزینه و دشوار بودن عمل جراحی برگشت باروری
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

106. عوارض غیر شایع احتمال تغيير ميزان خونریزی قاعدگی
خطرات بيهوشی مانند سایر اعمال جراحی
در صورت بروز مورد اول:
ارجاع به متخصص زنان
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

107. مواردی که انجام TL باید با تاخیر باشد:
بيماريهای التهابی لگن در سه ماهه اخير (3 ماه پس از درمان)
بيماریهای تروفوبلاستيك بدخيم
سابقه اخير بيماریهای قلبی حاد
ابتلا به DVT (ترمبوز ورید عمقی) يا آمبولی ريه
خونريزی واژينال بدون علت مشخص
مشكلات دوران بارداری، زايمان و پس از زايمان:
مانند پره اكلامپسی شديد، اكلامپسی، پارگی كيسه آب (بيش از24 ساعت)، تب زمان زايمان يا بلافاصله پس از آن، وجود عوارض پس از زايمان مثل خونريزي و عفونت ساير نقاط بدن(داشتن شرايط نامساعد جسمی)
STIبیماری فعال مقاربتی
سرطان های لگن
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

108. نكات مهم در TL
مشاوره دقيق در مورد کم بودن احتمال موفقیت و پر هزينه بودن عمل برگشت
توصيه اين روش فقط برای خانوا ده‌هایی كه دارای ثبات در زندگی هستند وتعداد فرزندان دلخواه خود را كامل كرده باشند
لزوم كسب رضايت زوجین
دقت به فاكتورهای سن متقاضی و تعداد و سن فرزندان در حين مشاوره به منظور كمك به تصميم گيری داوطلب
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

109. زمان انجام عمل TL
در هر زمان به شرط اطمينان از عدم بارداری متقاضی (دو هفته اول سيكل قاعدگی زمان مناسبتری است)
پس از زايمان طبيعی
هنگام سزارين (راحتی بستن لوله های رحمی)
نكته: نامناسب بودن عمل TLدر زمانهاي ذيل:
پس از سقط عفونی
در فاصله زمانی 42-7 روزپس از زايمان
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

110. ساير آزمايش ها در صورت لزوم
موارد لازم قبل از عمل TL
گرفتن سابقه بيماريها
انجام B-HCG
ساير آزمايش ها در صورت لزوم
معاينه لگنی
اندازه گيری فشارخون
پاپ اسمير
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

111. تذکرهای بعد از عمل TL استحمام روزانه استفاده از مسکن در صورت درد
تمیز و خشک نگه داشتن محل بخیه
نداشتن رابطه زناشویی تا یک هفته(تا رفع درد)
عدم نیاز به روش کمکی در روزهای اول پس از عمل
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

112. مراجعه‌های پیگیری
مراجعه در فاصله 7 روز بعد از عمل به منظور كشيدن بخيه ها و معاينه محل عمل
در صورت داشتن IUD قبل از انجام TL :
لزوم مراجعه فرد در اولين سيكل قاعدگی پس از عمل، برای خارج كردن IUD
در هر مراجعه:
بررسی رضايت ازعمل، عارضه ها، هشدارها، راهنمايی و مشاوره ( در صورت وجود مشكل خاص)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

113. تکنیک عمل جراحیTI روش شکمی: 2. هیستروسکوپ لاپاراسکوپی لاپاراتومی
مینی لاپاراتومی
ایجاد یک برش 3-2 سانتی متری در پایین شکم
برداشتن قطعه ای از لوله و یا مسدود کردن آن توسط نخ – حلقه – کلیپس و یا منعقد کردن با الکتروکواگولاسیون
2. هیستروسکوپ
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

114. National Family Health Survey-2
روش ایروینگ
National Family Health Survey-2

115. National Family Health Survey-2
روش پومری
National Family Health Survey-2

116. National Family Health Survey-2
روش یوشیدا
National Family Health Survey-2

117. National Family Health Survey-2

118. National Family Health Survey-2

119. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

120. No Scalpel Vasectomy (NSV)
جراحی سرپایی
بی حسی موضعی
مدت کمتر از 20 دقیقه
بسته شدن لوله های اسپرم بر
مكانيسم:
جلوگیری از ورود اسپرم به مایع منی
اثر بخشي:
نزدیک به 100%
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

121. مزایاي NSV اثر بخشی بالا – نیاز نداشتن به بیهوشی دائمی بودن
نداشتن اثر منفی بر قدرت مردانگی، میل جنسی و صفات ثانویه مردانه
عدم نیاز به یادآوری و مراجعه مکرر
نداشتن عارضه برای سلامتی در درازمدت
تاثیر نداشتن بر حجم و ظاهر مایع منی و کیفیت تماس جنسی
عدم تداخل با تماس جنسی
افزایش لذت جنسی بدلیل از بین رفتن نگرانی حاملگی ناخواسته
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

122. نیاز کمتر به مراقبتهای قبل و پس از عمل احتمال بيشتر موفقيت عمل بازگشت
در مقايسه با TL:
اثربخشی بیشتر
نیاز کمتر به مراقبتهای قبل و پس از عمل
احتمال بيشتر موفقيت عمل بازگشت
زمان كوتاهتر عمل
عوارض كمتر
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

123. درد، سوزش و کبودی مختصر در ناحیه عمل
عوارض شایع NSV
درد، سوزش و کبودی مختصر در ناحیه عمل
که تا یک هفته رفع می‌شوند
عدم عارضه درازمدت قابل توجه و سيستميك
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

124. اپیدیدیمو اورکیت عفونی اپیدیدیمیت احتقانی درد مزمن بیضه‌ها
عوارض غيرشایع NSV
هماتوم
عفونت پوست ناحیه عمل
اپیدیدیمو اورکیت عفونی
اپیدیدیمیت احتقانی
درد مزمن بیضه‌ها
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

125. آزمایش ها و معاینه‌های لازم قبل از NSV
شرح حال
معاینه عمومی
معاینه دستگاه ژنیتال
عدم نياز به انجام آزمايش خاص
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

126. دستورهای پس از عمل NSV استراحت تا یک روز آب نزدن به محل عمل تا دو روز
نداشتن تماس جنسی تا 4 روز
پوشیدن لباس زیر تنگ تا یک هفته
انجام ندادن کار سنگین تا یک هفته
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

127. تب بیش از 38 درجه تا 4 هفته (به‌ویژه در هفته اول)
هشدارها و روش برخورد
تب بیش از 38 درجه تا 4 هفته (به‌ویژه در هفته اول)
درد شدید و عدم پاسخ به مسکن
خروج خون و چرک از محل زخم
تورم بیش از حد اسکروتوم
ارجاع فوري به مركز وازكتومي
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

128. پیگیری و مراجعه های بعدی
معاینه به فاصله یک هفته پس از عمل
تست اسپرموگرام به فاصله های 3 و 4 ماه پس از عمل (بررسي آزوسپرمي)
استفاده از یک روش مطمئن ديگر در این مدت تا حصول اطمينان از آزواسپرمی
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

129. برگشت پذیری در NSV (Vasectomy Reversal)
80-60 درصد موفقیت عمل
بعد از عمل جراحی برگشت وازکتومی ظهور اسپرم در مایع منی تا 95 درصد موارد
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

130. روشهاي طبيعي(سنتی) تنظيم خانواده
انواع:
نزدیکی منقطع Coitus Interruptus- Male Withdrawal
روش قطع قاعدگی ناشی از شيردهيLactation Amenorrhs Method
روش های پرهیز دوره ای
روش تعیین گرماي پايه‌ بدن BBT: Basal Body Temperature
ترشح مخاطي گردن رحم (موکوس سرویکس) Billing Method
ريتم تقويمي Calendar rhythm
نکته مهم:هیچکدام از روشهای فوق موفقیت بالا ندارد و اصلاً قابل توصیه نیست.
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

131. روشهاي طبيعي تنظيم خانواده
مبنا:
پرهيز از تماس در حين و حول و حوش تخمك‌گذاري
عدم استفاده از وسيله يا داروي خاص
زمان معمول تخمك‌گذاري:
بين روزهاي 12 تا 16 سيكل
قابليت حيات تخمك: ساعت
قابليت حيات اسپرم: 3-5 روز(قابلیت باروری 48 ساعت)
كم بودن (نه صفر بودن) احتمال بارداري در قبل از روز 9 و بعد از روز 21 سيكل
موفقيت بيشتر در افراد با سيكلهاي منظم
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

132. روشBBT افزايش BBT در هنگام تخمك گذاري به ميزان 0/5 تا 0/3درجه
علت: افزايش پروژسترون
بررسي دمای بدن در هنگام صبح و پيش از برخاستن از خواب
پرهيز از تماس از روز شروع قاعدگي تا 3 روز پس از شروع افزايش BBT
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

133. National Family Health Survey-2
Dr Seyyed Alireza Moravveji Community Medicine Specialist
133
National Family Health Survey-2

134. روش مبتني بر ترشحات گردن رحم
نام ديگر: روش تخمك‌گذاري يا روش Billings
مشاهده روزانه تغييرات ترشح مخاط سرويكس:
بعد از خونريزي قاعدگي: خشك (علت: سطح پایین استروژن و پروژسترون) (عدم باروري)
هنگام تخمك‌گذاري: رقيق (باروري)
پس از تخمك‌گذاري: غليظ (تحت تأثیر پروژسترون) (عدم باروري)
پرهيز از تماس از شروع قاعدگي تا 4 روز پس از اتمام مشاهده ترشحات رقيق
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

135. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

136. National Family Health Survey-2
روش تقویمی
تعیین طول مدت دوره قاعدگی به مدت 12-6 ماه
زمان اجتناب از مقاربت در دوره باروری:
نخستین روز دوره باروری : با تفریق 18 روز (16 به اضافه دو روز طول عمر اسپرم) از کوتاهترین دوره
آخرین روز دوره باروری: با کم کردن 11 روز از طولانی ترین دوره( 12 روز منهای یک روز طول عمر تخمک)
National Family Health Survey-2

137. روش شيردهي براي اوايل زايمان (حداكثر 6 ماه)
مكيدن پستان توسط نوزاد از طريق افزايش پرولاكتين باعث كاهش آزاد شدن GnRh و از آن طريق كاهش ترشح LH شود.
هر زمان كه قاعدگي شروع شد، بايد از روش موثرتري استفاده شود.
موفقيت 98 درصد به شرط رعايت برخي نكات:
تغذيه انحصاري كودك با شير مادر (Exclusive Breast Feeding)
عدم شروع سيكلهاي قاعدگی مادر
شيردهي شبانه
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

138. نورپلانت
كپسول محتوي لوونورژسترول (با اثرات پروژسترونی قوي و اندروژنيك ضعیف)
اثر 5 ساله
كاشتن در زير پوست بازوي فرد با يك جراحي سرپايي
به دلیل داشتن عارضه لکه بینی (Spotting) و در نتیجه عدم استقبال مردم، از برنامه تنظیم خانواده ایران حذف شده است (به غیر از استان سیستان و بلوچستان)
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

139. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

140. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

141. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

142. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

143. زمان كاشتن نورپلانت
در هفت روز اول قاعدگي
بلافاصله پس از سقط يا در هفت روز اول پس از سقط
6 هفته پس از زايمان در زنان شيرده
حداكثر 4 هفته پس از زايمان در صورت عدم شيردهي
كاشتن نورپلانت با بي حسي موضعي و ايجاد شكاف كوچكي در زير پوست بازو و تحت شرايط استريل انجام مي شود و اين عمل جراحي كوچك حدود 10 دقيقه طول كشيده و نياز به بخيه ندارد . برداشتن آن هم 10 تا 15 دقيقه طول مي كشد.
The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..

144. The new National Population Policy, 2000, adopted by the Government of India, has set as its immediate objective the task of addressing unmet need for contraception in order to achieve the medium-term objective of bringing the total fertility rate down to replacement level by the year 2010.
The Reproductive and Child Health Programme is oriented to meet the health needs of women and children completely. With regard to family planning, the approach emphasizes the
target-free promotion of contraceptive use among eligible couples;
the provision to couples of a choice of contraception; and
the assurance of high-quality care.
An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births……..