Review of Contraception with Depot Medroxyprogesterone Acetate at the University of Port Harcourt Teaching Hospital, Port Harcourt, Southern Nigeria

Abstract

Aims: To re- evaluate the use, effectiveness, acceptability and side effects of depot medroxyprogesterone acetate in Port Harcourt, Southern Nigeria. Study Design:  Descriptive retrospective analysis. Place and Duration of Study: Family planning clinic, University of Port Harcourt Teaching Hospital, (UPTH), Port Harcourt Nigeria, between 1st January 2004 and 31st December, 2013. Methodology: The case files of all new clients who accepted and used depot medroxyprogesterone acetate  at the UPTH were retrieved and their data including the socio-demographic characteristics, side effects, reasons for family planning extracted, coded and entered into a data bank and analysed using SPSS for windows 19.0 version and results expressed in percentages and presented in tables and figures. Results: Six hundred and seventy seven clients out of the total of 7001 new acceptors of contraception during the study period used depot medroxyprogesterone acetate (DMPA) giving an uptake rate of 9.7%. Three hundred and fifty three (52.1%) used it for child spacing while 324 (47.9%) used it for terminal fertility control. Secondary amenorrhea remained the commonest side effect occurring in 503 (74.3%) women. Up to 482 (71.2%) clients were lost to follow up, 43 (6.5%) discontinued voluntarily while 145 acceptors continued to use DMPA, giving a continuation rate of 22.5%. No unintended pregnancy occurred at the end of the observation period, giving a Pearl Index of 0/100 woman years. Conclusion: Depot medroxyprogesterone acetate is highly effective and safe method of fertility control but with declining acceptability, high default and low continuation rates.