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PubMed1981

The copper-7 intrauterine contraceptive device: 5-year evaluation.

Over a 5-year period a family practitioner inserted copper-7 (Cu-7 intrauterine contraceptive devices (IUDs) in 134 women. The rates of continued use after 2 years, 53.0% for the women's first IUD and 63.9% for all their IUDs, and of accidental pregnancy, 2.4%, are comparable to those in the literature. However, in this series the rate of expulsion was 0.8%, much lower than that in the literature. Fertility did not appear to be reduced in women who planned to have pregnancies after the device was removed. A carefully scrutinized technique of insertion and conscientious follow-up make the Cu-7 IUD an acceptable form of contraception for many patients in a family practice.

Adolescent↗
PubMed1998

The impact of intrauterine contraceptive devices on cytological findings from routine Pap smear testing.

OBJECTIVE: To evaluate the impact of intrauterine contraceptive device (IUCD) use on the interpretation of routine Pap smears. STUDY DESIGN: A retrospective case-control study. PATIENTS AND METHODS: During a 2-year period, we evaluated the Papanicolaou (Pap) tests of 452 consecutive asymptomatic women of childbearing age who used a copper IUCD (study group), and 452 matched controls who practiced no contraceptive methods (control group). RESULTS: Inflammatory exudate, inflammatory epithelial changes or extensive metaplastic cells were more commonly encountered among the IUCD user as compared with non-users (p < 0.05). No difference was noted in the detection rates of cervical squamous intraepithelial lesions in the two study groups. CONCLUSIONS: It can therefore be concluded that the use of an IUCD does not increase the incidence of squamous intraepithelial lesions. Any abnormal Pap smear in an IUCD user should first be repeated after local vaginal treatment, if only to temporarily palliate the inflammatory cellular reaction which impedes unequivocal interpretation of the routine Pap smear.

Adult↗
PubMed1996

Mechanism of action of the intrauterine contraceptive device: evidence for a specific biochemical deficiency in the endometrium.

The precise mechanism of action of the intrauterine contraceptive device (IUCD) is uncertain. In this study we compared the circulating concentrations of a specific endometrial protein, placental protein 14 (PP14), in 62 women with an IUCD and 16 controls. The concentrations of PP14 were substantially lower in IUCD users. There was no difference in the concentrations of another and less specific endometrial protein, insulin-like growth factor binding protein-1 (IGFBP-1). There was no difference in PP14 concentrations between those women with and without intermenstrual bleeding. We conclude that the reduced concentrations of PP14 in IUCD users reflect defective endometrial function in these women, probably related to the contraceptive effect. We propose that the measurement of PP14 might be a means of comparing the efficiency of different devices.

Adult↗
PubMed1995

Endometrial morphometry in users of intrauterine contraceptive devices and women with ovulatory dysfunctional uterine bleeding: a comparison with normal endometrium.

Copper-bearing intrauterine contraceptive devices (IUCD) are commonly associated with menorrhagia. They cause certain morphological changes in the endometrium. These have been extensively reported and the mechanisms of menorrhagia have been investigated in a number of studies. By contrast, ovulatory dysfunctional uterine bleeding has not been as widely studied and mechanisms of menorrhagia in these patients are still not well understood. In this study, we examined endometrial morphometry in a group of women using IUCD, a group of women with ovulatory dysfunctional bleeding, and a control group of women with entirely normal cycles. There was increased leukocytic infiltration of the endometrium in both groups of women with menorrhagia compared to control cases. In addition, IUCD use was associated with greater luteal phase glandular epithelial height, supporting the concept of a secretory function defect in glandular epithelium. Possible links are postulated between static morphometric observations and dynamic biochemical changes.

Australia↗
PubMed1976

An association between the Dalkon Shield and complicated pregnancies among women hospitalized for intrauterine contraceptive device--related disorders.

A nationwide mail survey of virtually all physicians likely to be involved with intrauterine contraception resulted in 3,502 unduplicated reports of intrauterine contraceptive device (IUD)--related hospitalizations during the first six months of 1973. Dalkon Shield use was significantly more frequent among women hospitalized for a complicated pregnancy than those hospitalized for a non-pregnancy-related disorder. Although the observed association was not substantially altered by stratifications of the mail survey reports by the patient's age, race, or geographical region, the association did not apply to those women whose IUD's were explicitly reported to be of the nulliparous size. Interviews conducted with a probability sample of physicians who had not responded to the survey confirmed that the association between the Dalkon Shield and complicated pregnancy also existed in their experience. An association between the standard Dalkon Shield and complicated pregnancies might reflect an increased rate of pregnancy with this device, an increased rate of complications occurring after zygotic implantation, or perhaps both. Whatever the explanation, the observed association is sufficiently widespread to require further investigations.

Adolescent↗
PubMedDate not supplied

Complications of intrauterine contraceptive device (IUD) use at the University of Ilorin Teaching Hospital, Ilorin.

BACKGROUND: The use of Intrauterine Contraceptive Device (IUD) has increased steadily worldwide over the years. METHODS: This is a retrospective study of 602 women who had IUD insertions at the Family Planning Unit of the University of Ilorin Teaching Hospital between January- December 1995 and the study was undertaken to study the complications associated with the IUD use at the University of Ilorin Teaching Hospital. RESULTS: There was 85.55% continuation rate after a year, 81.06% of patients were without complications, 0.33% had Pelvic Inflammatory Disease (PID) and no perforation was reported. Expulsion was also low. Mean duration of use was 14.06 +/- 4.46 months. There was no statistical difference in timing of insertion in those with or without complications (p = 0.781); however, a significant difference becomes noticeable in the duration of use of the IUD in the two groups (p = 0.001). IUD was acceptable to most patients (85.5%). There was no significant difference with respect to level of education (p = 0.064) and type of previous contraception practised (p = 0.022) in those with or without complications. IUD complications were commonest within the first 3 months of insertion; involving a third of those lost to follow-up compared with about 15% of those not lost to follow-up (p = 0.001). CONCLUSIONS: At the University of florin Teaching Hospital, Ilorin, IUD use is safe and effective with minimal complications.

Adolescent↗
PubMed1975

Postpartum and postabortal insertion of intrauterine contraceptive devices.

One hundred forty-four patients are studied over an 18 month period. Postpartum and postabortal insertions of intrauterine contraceptive devices using the Lippes Loop and the Dalkon Shield are compared. The age, parity, previous methods of contraception, and marital status of the study group indicated a poorly motivated patient population. Although accidental pregnancy rates and expulsion rates are higher, the technique is considered worth-while in the population studied. Future research should be directed toward improved devices in order to decrease side effects and to increase appeal of the technique to those who will benefit most.

Abortion, Induced↗
PubMed1988

The effect of a copper intra-uterine contraceptive device on the microbial ecology of the female genital tract.

Bacteria isolated from 108 intra-uterine contraceptive devices (IUCD) removed from patients with pelvic inflammatory disease (PID), haemorrhage, pregnancy and from asymptomatic women, and from the genital tracts of 66 healthy controls not wearing an IUCD, were studied. No significant differences were found in the types of micro-organisms or isolation rates from IUCDs removed from women in the various clinical groups. The isolation rate of anaerobic bacteria from IUCDs removed from asymptomatic wearers was significantly lower than that from controls, with the exception of the isolation rate of actinomyces which was significantly higher in IUCD wearers and A. israelii was recovered only from IUCDs. The isolation rates of the different bacterial species varied with the duration of the device in utero. The presence of a copper IUCD altered the bacterial flora of the female genital tract. The insertion of such a device and the ecological changes that follow play a crucial role in the development of PID.

Actinomyces↗
PubMed2002

Diagnosis and management of lost intrauterine contraceptive device.

OBJECTIVE: To study the pattern of referral, method of diagnosis and management of patients admitted with lost Intrauterine Device (IUD). METHODS: A prospective study was conducted about lost intrauterine contraceptive devices and its management, in Gynaecology Department of Nishtar Hospital, Multan. Twenty eight patients with lost IUD were identified out of 7816 gynaecology admissions, during this period. The diagnosis was made on ultrasonography. RESULTS: IUDs were removed after dilatation of cervix and exploration of uterine cavity in 20 patients. Five cases underwent laparotomy, in 2 cases laparoscopic removal was done and in one case IUD was taken out through proctoscope. In most of the cases IUD was inserted by untrained personnel. CONCLUSION: It is recommended that IUDs should be inserted after proper case selection by trained medical professionals.

Adult↗
PubMed1994

The localization and concentration of copper in the fallopian tube in women with or without an intrauterine contraceptive device.

The localization and concentration of copper in cryostat sections of human fallopian tubes from women using an intrauterine contraceptive device (IUCD) and controls was determined by light microscopic- and atomic absorption spectrophotometric techniques. The copper was visually accumulated in the epithelium and the copper concentration in the tubal tissue was increased in the IUCD user group. We also measured the concentration of copper and ceruloplasmin in serum, but there was no statistical difference between the two groups studied. Our results indicate that the IUCD has effects beyond the uterine cavity. The accumulation of copper may be associated with earlier observations of the morphological changes and infiltration of inflammatory cells observed in the fallopian tube in IUCD users.

Adult↗
PubMed1998

A review of bacteriological culture of removed intrauterine contraceptive devices.

A retrospective review of clinical and microbiological data was made, over an 18 month period, of intrauterine contraceptive devices removed and sent for examination. An association with symptoms at time of removal was found for Streptococcus agalactiae, Streptococcus milleri, enterobacteria and obligate anaerobes. Thirty four per cent of IUDs yielded one or more Actinomycesspecies spp but no correlation with symptoms was found. In the small group of symptomatic patients who were followed up, no difference in outcome was observed between those who were treated with antibiotics and those who were not.

Anti-Bacterial Agents↗
PubMed1980

Specific serum protein levels in women using intrauterine contraceptive device.

The report is concerned with the levels of 17 specific serum proteins in 46 women using plastic nonmedicated intrauterine contraceptive device (IUCD) Dana-Super. Blood samplings were carried out three times: just before the IUCD introduction, 30 and 54 weeks after the insertion of IUCD. The following proteins except haptoglobin were quantitatively determined by radial immunodiffusion: prealbumin, albumin, orosomucoid, alpha 1-antitrypsin, ceruloplasmin, alpha 2HS-glycoprotein, alpha 2-macroglobulin, hemopexin, C3-component, transferrin, beta 2-glycoprotein I, C-reactive protein and immunoglobulins IgG, IgA, IgM and IgD. Moderately increased values were found for alpha 2HS-glycoprotein and beta 2-glycoprotein I in sera taken 30 weeks after the insertion of IUCD. AT the same time the augmentation of alpha 1-antitrypsin was established. This might be evoked by the raised protease activity in biological fluids of genital region. The raise in consequence of IUCD application of transferrin and the decrease of haptoglobin at the first postinsertion examination and the decrease of hemopexin and albumin at the second may be associated with higher menstrual bleeding followed by iron deficiency. All other proteins as well as the acute phase proteins showed only minor if any differences as compared with the corresponding start values. Similarly, there is no evidence of a systemic immunoglobulin response to IUCD use.

Adolescent↗
PubMed1994

Doppler study of the uterine artery in patients using an intrauterine contraceptive device.

A Doppler flow study of the uterine artery was performed using transvaginal sonography in 68 women, including 44 using an intrauterine contraceptive device (IUCD) and 24 control women who were not using any method of contraception. Both the pulsatility index (PI) and resistance index (RI) were significantly lower in women with IUCD-induced bleeding than in those without abnormal vaginal bleeding (p < 0.001) or in women not using any method of contraception (p < 0.001). No significant variations in PI and RI levels (p > 0.05) were found with the duration of IUCD application or the duration of IUCD-induced bleeding in patients using the device. Also, no significant changes in blood flow indices were demonstrated between women using the device without abnormal vaginal bleeding and the control group. These preliminary results suggest that some women are more prone to develop IUCD-induced bleeding than others, and this bleeding may be due to decreased vascular resistance in the uterine artery. Transvaginal Doppler study of the uterine artery may be a helpful technique to identify such women.

Journal Article↗
PubMed1998

Norplant as a contraceptive device in Enugu, eastern Nigeria.

This paper is an evaluation of acceptability and use-experience with the contraceptive device Norplant at the University of Nigeria Teaching Hospital, Enugu, Eastern Nigeria. Over a period of 36 months, 173 women (8% of the clinic population) accepted the implant. Use of Norplant was concentrated among high-parity women, and the proportion of Norplant users was highest among women aged 30-34 years. Comparing Norplant and IUD users, we found Norplant users to be significantly less highly educated with < 1% of Norplant users having tertiary education compared to 25% of new IUD users. The continuation rate with Norplant was 89% at three years, suggesting this method has the potential for improving the low contraceptive prevalence in this region.

Age Distribution↗
PubMed1981

A study to determine the effect of Betadine Vaginal Cleansing Kit on cervical flora after insertion of an intra-uterine contraceptive device.

Twenty-four women with negative high vaginal swabs, who attended for insertion of an intra-uterine contraceptive device, were randomly allocated to two groups. One group used the Betadine Vaginal Cleansing Kit before and after insertion of the intra-uterine device; the other group did not use any cleansing agent. After 4 to 6 weeks, the patients were re-examined and a cervical swab was taken. The bacteriological findings were of interest and significance. In the study group there was bacterial in only one patient out of the twelve, whereas in the control group there was bacterial growth in ten out of the twelve. The bacteria grown were of doubtful clinical significance, but in certain circumstances they could take a pathogenic role. The marked absence of bacterial growth in the study group is significant because, during a 4 to 6 week period, the cervical mucus remained sterile thus minimizing the risk of pelvic infection during and immediately after insertion. Whether is has any significant effect in the long-term reduction of the incidence of pelvic infection remains to be seen, and further studies are needed.

Adolescent↗
PubMed2006

Revisiting the intrauterine contraceptive device in adolescents.

STUDY OBJECTIVE: The purpose of this study was to report on our experience with the intrauterine contraceptive device (IUCD) in a group of properly counseled adolescents and to determine whether traditional hesitation with use in this population should be reconsidered. DESIGN: Patients who had an IUCD inserted between April 1999 and March 2003 were identified using medical records and chart review. SETTING: A single Canadian University teaching hospital supervised by a single gynecologist. PARTICIPANTS: Twenty-eight patients, 21 years of age and under, were identified. Twenty agreed to participate in the study. INTERVENTIONS: Patients were contacted by mail to inform them of the study and subsequently interviewed using a 10-minute structured phone interview that contained seven primary questions with additional follow-up questions. MAIN OUTCOME MEASURES: Duration of use, reasons for removal, side effects experienced, satisfaction with use, prior contraception. RESULT: The average age at insertion was 18.7 years, the average time of use was 19.6 months and the average number of pregnancies prior to insertion was 1.4. Seven patients (35%) had discontinued use of their IUCD prior to the interview, with an average of 13.4 months between the time of insertion and removal. The most common reason for removal was increased bleeding. The most common side effect was increased cramping. Eighty-five percent (17/20) of users were either somewhat satisfied, satisfied or very satisfied with the IUCD. CONCLUSIONS: Following pre-insertion screening for STI-related cervicitis and with consistent follow-up following insertion, IUCDs are well-tolerated by properly selected and counseled adolescents who require an easy and effective long-term method of birth control.

Adolescent↗