Introduction Our primary objective was to evaluate whether new types of single-size diaphragms or cervical caps differ in prevention of pregnancy compared with older types of diaphragms, and whether different types of gels differ in their ability to prevent pregnancy. A secondary aim was to evaluate method discontinuation and complications. Methods A comprehensive search was conducted in PubMed, Embase and the Cochrane Library. The certainty of evidence was assessed according to the GRADE system. Results Four randomised controlled studies were included in the assessment. When comparing the new and old types of female barrier contraceptives the 6-month pregnancy rate varied between 11%–15% and 8%–12%, respectively. More women reported inability to insert or remove the FemCap device (1.1%) compared with the Ortho All-Flex diaphragm (0%) (p<0.0306). Urinary tract infections were lower when using the single-size Caya, a difference of −6.4% (95% CI −8.9 to −4.09) compared with the Ortho All-Flex diaphragm. The 6-month pregnancy rate for acid-buffering gel and spermicidal nonoxynol-9 gel varied between 10% and 12%. The discontinuation rate was lower in women who used acid-buffering gel compared with nonoxynol-9 gel (risk ratio (RR) 0.77, 95% CI 0.68 to 0.97). Conclusions Pregnancy rates were generally high in women using female barrier contraceptives. There was no difference in the efficacy for pregnancy prevention between the new types of diaphragms and cervical caps and the older diaphragms. The new types of diaphragms and cervical caps resulted in fewer urinary tract infections. Acid-buffering gels did not differ from spermicidal nonoxynol-9 gels regarding pregnancies but seemed to be better tolerated.

中文翻译：

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新型隔膜和宫颈帽与旧类型隔膜和不同避孕凝胶的比较：系统评价

介绍 我们的主要目的是评估新型单尺寸隔膜或宫颈帽与旧类型隔膜相比在预防怀孕方面是否有所不同，以及不同类型的凝胶在预防怀孕的能力方面是否有所不同。次要目的是评估方法中断和并发症。方法 在 PubMed、Embase 和 Cochrane 图书馆中进行了全面搜索。根据 GRADE 系统评估证据的质量。结果 评估中包括四项随机对照研究。在比较新旧类型女性屏障避孕药时，6 个月的妊娠率分别在 11%–15% 和 8%–12% 之间变化。与 Ortho All-Flex 隔膜 (0%) 相比，更多女性报告无法插入或移除 FemCap 装置 (1.1%) (p<0. 0306）。使用单尺寸 Caya 时尿路感染较低，与 Ortho All-Flex 隔膜相比差异为 -6.4%（95% CI -8.9 至 -4.09）。酸缓冲凝胶和杀精子 nonoxynol-9 凝胶的 6 个月妊娠率在 10% 和 12% 之间变化。与 nonoxynol-9 凝胶相比，使用酸缓冲凝胶的女性的停药率较低（风险比 (RR) 0.77，95% CI 0.68 至 0.97）。结论 使用女性屏障避孕药的女性怀孕率普遍较高。新型隔膜和宫颈帽与旧隔膜在预防怀孕的功效上没有差异。新型隔膜和宫颈帽减少了尿路感染。