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At least 199 records · Page 11Linked to original sources
PubMed1984

Degradation of the copper-releasing intrauterine contraceptive device and its significance.

Measurements were made of the copper remaining on used Gravigard intrauterine contraceptive devices (IUCDs) that had been in utero for up to 40 months. The topography and composition of the surface deposits were analysed by scanning electron microscopy and energy-dispersive X-ray analysis. The rate of copper loss decreased exponentially from 0.42 mumol d-1 (26.7 micrograms d-1) upon insertion to 0.056 mumol d-1 (3.6 micrograms d-1) after 26 months of use; between 27 and 40 months of use a linear release of 0.32 mumol d-1 (20.3 micrograms d-1) was observed. There was no correlation between this changing rate of copper loss and the pregnancy rate with the device in situ. The changes in the rate of copper loss were probably due to the growth of a surface corrosion product which, due to internal stresses, fractured after about 2 years and exposed fresh copper; this results in a progressive increase in breakage of the copper wire after 3 years. It is recommended that a copper IUCD of this type be replaced after 3 years.

Copper↗
PubMed1992

Randomised comparative study in 217 women of three disposable plastic IUCD thread retrievers.

OBJECTIVE: To assess the relative efficacy of three disposable plastic instruments in the retrieval of 'missing' IUCD threads. DESIGN: A prospective randomised comparative single centre study. SETTING: Family Planning Clinic in London, UK. SUBJECTS: 217 of 350 IUCD users referred to the research team with 'missing' IUCD threads entered the study. INTERVENTION: All women initially underwent exploration of the endocervical canal with Spencer Wells forceps. When this procedure did not retrieve the threads, the patients were entered into the study. A maximum of two randomly chosen plastic IUCD thread retrievers were then used in any one patient to explore the uterine cavity and capture the 'missing' threads. The order in which the two retrievers were employed was also determined at random. Four separate entries into the uterine cavity were permitted with each instrument, the endocervical canal being explored with Spencer Wells forceps after each retraction of the instrument to identify the possible descent of the threads. MAIN OUTCOME MEASURES: Threads brought down beyond the external cervical os, or threads brought to within the endocervical canal and then grasped by Spencer Wells forceps. RESULTS: In approximately 40% of all patients, the threads were retrieved with Spencer Wells forceps alone and a further 40% with the disposable plastic retrievers. About 5% had no retrievable threads, and only 2.5% of the referred patients required general anaesthesia for removal of their IUCD. The analysis of the comparative trial was confined to the 197 patients with retrievable threads which could not be brought below the external os with Spencer Wells forceps. The first plastic retriever used was successful in 50% of patients. The Retrievette (59%) and the Emmett (53%) performed better than the Mi-Mark Helix (37%) in this study. The difference was statistically significant (P = 0.03) and the 95% confidence interval for the difference of the Mi-Mark Helix from the other two retrievers was 4% to 33%. This retrieval rate for the Mi-Mark Helix was much worse than in previously reported studies, though one doctor did have a better success rate with this retriever. The success rates, using a second plastic retriever randomly chosen from the two not used in the first attempt, were almost identical to those observed with the first retrievers: 63%, 56% and 36%. The success rate did not appear to be influenced by the length of thread, day of cycle, device type or parity. The success of the second retriever tried did not seem to be influenced by the retriever that had failed previously. CONCLUSIONS: Based on our experience, the initial exploration of the endocervical canal with Spencer Wells forceps is invaluable. If this simple manoeuvre fails to retrieve the 'missing' threads, either the Retrievette or the Emmett thread retrievers are useful tools in general practice or in the family planning clinic setting.

Female↗
PubMed1997

Experience of Finnish women with Norplant insertions and removals.

OBJECTIVE: Norplant and Norplant-2 have been available for use by Finnish women since 1984 and 1986, respectively. The objective of this study was to explore Norplant users' experiences of insertions, removals and medical treatments. DESIGN: A questionnaire was sent to women who had received Norplant or Norplant-2 implants one to two years earlier (n = 262) in normal clinical settings; the response rate was 79%. RESULTS: At insertion, problems were experienced by 9% and at least some pain by 23% of women. During the first year 20% of all users (14% of Norplant and 33% of Norplant-2 users) had their implants removed. Problems were experienced at removal by 33% of women and pain was experienced by 40%; nevertheless most users were satisfied with the device. Findings were similar for the two types of Norplant. Forty-two percent of the women had received minipills containing levonorgestrel before Norplant insertions in an attempt to assess Norplant's suitability, and 8% had received drugs for adverse effects caused by Norplant. CONCLUSIONS: Studies including perspectives of Norplant users and the whole lifespan of Norplant (including removal) should be conducted in all clinical settings where Norplant is provided.

Contraceptive Agents, Female↗
PubMed1991

Changes in haemostasis after stopping the combined contraceptive pill: implications for major surgery.

OBJECTIVE: To investigate the changes in haemostasis in the three months immediately after stopping the combined contraceptive pill. DESIGN: Prospective randomised study. SETTING: Family planning centre in London. SUBJECTS: 24 women aged 35-45 investigated before, during, and after six months' use of combined oral contraceptives containing 30 micrograms ethinyl oestradiol together with the progestogens desogestrel or gestodene. MAIN OUTCOME MEASURES AND RESULTS: Blood samples were taken immediately before and after six months of oral contraceptive use and one, two, four, six, eight, and 12 weeks after the pill had been stopped. During the six months of oral contraceptive use the plasma concentration of factor X and fibrinogen increased and that of antithrombin III decreased. Between two and six weeks after stopping the pill a rebound phenomenon occurred with plasma concentrations of antithrombin III increasing (mean change from baseline at two weeks 0.06 IU/l and at six weeks 0.10 IU/l) and fibrinogen decreasing (0.26 g/l change at two weeks and 0.40 g/l at six weeks). Factor X concentrations fell gradually and the values at eight weeks were not significantly different from those found before the combined pill was started. CONCLUSION: The combined pill should be stopped at least four weeks before major surgery, which carries the risk of postoperative thrombosis, to allow the potentially prothrombotic haemostatic changes that occur during its use to be corrected.

Adult↗
PubMed1994

Localization of contraceptive implant capsules for removal.

Implanted contraceptive capsules occasionally cannot be removed by means of palpation with local dissection, and imaging guidance is necessary. The authors report obtaining a single antero-posterior radiograph of the upper arm followed by sonography to localize the capsule and to allow precise marking of the skin over the capsules. The method can be performed quickly and is inexpensive and effective, allowing the localization and removal procedures to be scheduled independently.

Adult↗
PubMed1989

Oral contraception and post-operative thromboembolism: an epidemiological review.

It has been stated that oestrogen-containing oral contraceptive medication should be discontinued one month prior to surgery, to avoid an increased incidence of post-operative thromboembolism. Others have suggested that the risk of post-operative morbidity is low compared with the risk of pre-operative pregnancy, and that in most cases no such action should be taken. The evidence from clinical investigation is reviewed, with particular reference to study design. It is found that all studies so far conducted are subject to sources of bias or confounding which render their results inconclusive. There is a need for a randomised control trial comparing the effects of discontinuing or continuing oral contraception prior to surgery. Meanwhile, with a post-operative risk inferred but not conclusively demonstrated, if oral contraception is to be withdrawn prior to surgery, great care must be taken to reduce the risk of ensuing pregnancy to as near zero as possible.

Adolescent↗
PubMed1996

Contraceptive use among female adolescents.

Teenage pregnancy continues to be a problem in the United States despite the availability of reliable contraceptive methods. A pilot study was conducted to determine the use of reliable contraception by teenagers following an abortion or negative pregnancy test. The results indicated that 96.6% of the teenagers experiencing a therapeutic abortion and 49.6% of the teens having a negative pregnancy test reported choosing reliable contraception after the procedure or the test. At a subsequent clinic visit, however, only 27.5% in the abortion group and 5.7% in the negative pregnancy test group reported use of reliable contraception. Further research is needed to identify factors involved in teenagers' use or nonuse of contraception.

Abortion, Legal↗
PubMed1977

Outcome of pregnancy in the presence of intrauterine device.

The outcome of 196 pregnancies with Lippes Loop in situ was studied. In 102 cases with inaccessible thread, the IUD was left in place. Ninety-four women had the IUD removed when the thread was still visible. The incidence of spontaneous abortion and premature delivery was 56.8% in the group of 102, and was significantly higher than in those women whose loop was removed. No serious complications occurred in any of the cases. The results suggested that the IUD should be removed early in pregnancy when the string is still accessible.

Abortion, Spontaneous↗
PubMed1978

Fracture and chemical composition of the deposit formed on the Lippes loop after prolonged use.

In order to confirm or refute the theory that there is the need to replace IUD's every few years due to their breaking, 26 Lippes Loops were tested. The sediment found on the devices was composed mainly of calcium carbonate. After removal of the sedimentation, it was seen that there was some corrosion of the body of the devices which caused a decrease in the IUD thickness. Pressure tests showed that an IUD which has been in use for a long period of time is more rigid, has less ability to deform and breaks under less pressure. It seems that the current medical opinion stating that IUD's should be replaced every few years, is valid.

Calcium Carbonate↗
PubMed1979

Some adverse effects of copper-IUD.

Perforations and extraction problems in some 30 700 women wearing a copper intrauterine device (Cu-IUD), either a Cu-7 or Cu-T have been studied. Perforations were very rare. Judging from the literature and the present investigation, in cases of perforation the Cu-7-IUD has a tendency to penetrate the uterine wall and the Cu-T-IUD the cervical wall. Retracted and detached strings were observed somewhat more often in women wearing Cu-7-IUD's. The number of such cases was, however, not large enough to warrant a statistical comparison. The cause of retention, investigative procedures and recommendations in the removal of lodged Cu-IUD's are discussed.

Cervix Uteri↗
PubMed1983

Lack of correlation between contraceptive pills and Down's syndrome.

A case-control study has been made on the use of oral contraceptives before pregnancy and the birth of an infant with Down's syndrome. Controls were matched for age and parity and selected from the Medical Birth Register. Information on Pill usage was obtained from the Swedish standardized maternity health record which contains dates for when the women stopped using the Pill and for last menstrual period. There was no indication of any relation between the use of oral contraceptives and Down's syndrome.

Adolescent↗
PubMed1983

A rare case of IUD expulsion through the fallopian tube.

This case report describes the expulsion of an IUD (Gravigard) through the Fallopian tube. Such a phenomenon has been suggested earlier but never reported. It is concluded that the shape of the IUD is of importance for such a route of expulsion.

Adult↗