Abstract
100 000 quinacrine nonsurgical female sterilizations have been completed over the past decade involving transcervical insertion of quinacrine (252 mg) as pellets by one, two or three monthly insertions. No deaths have been reported and serious complications are far fewer than for surgical sterilization. Side-effects are mild and transient. Efficacy has improved from 3 pregnancy failures per 100 women at one year to approximately 1 by improved insertion technique and use of adjuvants. Long-term follow-up of early cases in Chile shows no increased risk of cancer for this method.
The main advantage of quinacrine sterilization is its ability to raise contraceptive prevalence and thereby reduce maternal mortality and morbidity, especially in rural and urban slum areas of developing countries. It should be made available as an option to well informed women everywhere as an economical and safe permanent family planning method.
Resumé
Au cours de la décennie écoulée, 100.000 femmes ont été stérilisées par intervention non chirurgicale, sous forme de pellets de 252 mg de quinacrine à raison d'une, de deux ou de trois insertions mensuelles par voie transcervicale. Aucum décès n'a été enregistré et les complications graves ont été moins fréquentes que lors de stérilisations chirurgicales. Les effects secondaires sont bénins et passagers. L'utilité de la méthode s'est améliorée, passant de 3 échecs par grossesses à 1 pour 100 femmes au terme d'un an, grâce au perfectionnement de la technique d'insertion et de l'emploi d'adjuvants. Le suivi à long terme des premiers cas au Chili n'a pas révélé l'accroissement d'un risque de cancer pour cette méthode.
Le principal avantage de la stérilisation à la quinacrine vient de ce qu'elle permet de rehausser la prévalence contraceptive et, par conséquent, de réduire la mortalité et la morbidité maternelles, surtout dans les zones rurales et les quartiers pauvres des villes de pays en développement. Cette méthode devrait être présentée comme option ouverte aux femmes bien informées, dans quelque pays que ce soit, et comme une méthode de planning familial économique, sans danger et permanente.
Resumen
En los últimos diez años se realizaron 100.000 esterilizaciones femeninas no quirúrgicas con la inserción transcervical de 252 mg de quinacrina en forma de bolitas mediante inserciones cada mes o cada dos o tres meses. No se notificó ninguna muerte y las complicaciones graves son mucho menos frecuentes que en el caso de la esterilización quirúgica. Los efectos secundarios son leves y pasajeros. La eficacia mejoró de 3 fracasos con embarazos por cada 100 mujeres al año a aproximadamente 1 mediante una mejor técnica de inserción y el uso de adyuvantes. El seguimiento a largo plazo de los primeros casos en Chile no señala un riesgo más alto de cáncer al utilizarse este método.
La ventaja principal de la esterilización con quinacrina es su capacidad de aumentar la prevalencia anticonceptiva y reducir así la mortalidad y morbilidad maternas, especialmente en zonas rurales y en barriadas urbanas de países en desarrollo. Debe facilitarse como opción a mujeres bien informadas de todas partes, como método económico y seguro de planificación familiar permanente.
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Kessel, E. 100 000 quinacrine sterilizations. Adv Contracept 12, 69–76 (1996). https://doi.org/10.1007/BF01849629
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DOI: https://doi.org/10.1007/BF01849629