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PubMed1990

Cervical pathology with intrauterine contraceptive devices--a cyto-colpo-pathological study.

One-hundred Lippes loop and 100 Cu T-200 intrauterine contraceptive device (IUCD) users, for more than one year, and 200 control non-users were examined clinically, cytologically, colposcopically and histopathologically for associated cervical pathological lesions. Nonspecific infection increased significantly in both Lippes loop and Cu T-200 IUCD users, compared to non-users (P less than 0.05). On the other hand, there was no statistically significant difference in the incidence of total, or individual, specific infections, dyskaryosis or CIN between both groups (P greater than 0.05). Colposcopically, there was a significant increase in inflammatory changes with both Lippes loop and Cu T-200 IUCD, compared to controls (P less than 0.05), but there was no difference in other colposcopic findings (P greater than 0.05).

Cervix Uteri↗
PubMedDate not supplied

Perforation of the rectum by a Copper-T intra-uterine contraceptive device; a case report.

A case of a rare complication of a Copper-T intra-uterine contraceptive device (IUCD) producing uterine and rectal perforation is reported. The patient presented with the threads of the IUCD protruding through the anus and the device was removed from the rectum using a proctoscope. A review of the literature revealed only seven cases of perforation of the rectosigmoid by an IUCD in which the device was removed per rectum, and this report documents the first of such cases involving a Copper-T. Proctosigmoidoscopic evaluation is recommended whenever perforation of the rectosigmoid by an IUCD is suspected, since it may select those patients for whom rectal recovery of the IUCD is feasible, thus avoiding unnecessary surgical intervention.

Adult↗
PubMed1976

Diagnostic ultrasound in the management of patients using intrauterine contraceptive devices.

A group of 80 patients was scanned by ultrasound within 24 hours of insertion of an intrauterine contraceptive device (IUCD) and re-examined clinically and/or by ultrasound after the next menstrual period. An attempt was made to identify factors such as uterine size, uterine flexion and the position of the IUCD which might be related to its expulsion or removal when, on initial scanning, the device was not located in the fundal area; removal was necessary in 5 out of 6 patients. In patients with an endometrial cavity of less than 40 mm length and/or acute uterine flexion, the overall figure for expulsion and removal was 54 per cent (13 out of 24). It is hoped that a consideration of these factors will lead to a reduction of the failure rate of the IUCD.

Cervix Uteri↗
PubMed1998

Use of intrauterine contraceptive devices in nulliparous women: personal experience over a 12-year period.

OBJECTIVE: To evaluate the use of intrauterine contraceptive devices (IUDs) in nulliparous women compared to their use in parous women. METHODS: A comparative cross-sectional study was carried out to determine the reasons for removal of IUDs inserted between 1985 and 1996 in a sample of 227 nulliparous women and 2080 parous women. The statistical analysis was performed using the chi 2 test; the differences were considered to be significant when p < 0.05. RESULTS: The reasons for removal of IUDs in the two groups were: expiry, 49.1% in the nulliparous group vs. 48.2% in the parous group; planned pregnancy, 21.7% vs. 15.4%; accidental pregnancy, 4.8% vs. 6.3%; expulsion, 1.6% vs. 5.1%; pelvic inflammatory disease, 1.6% vs. 1.1%; pain and/or bleeding, 14.5% vs. 10.2%; other, 6.4% vs. 6.3%; vasectomy or tubal sterilization, 0% vs. 7%. CONCLUSION: Our data suggest that nulliparity is not a contraindication for the use of an IUD, and that the use of an IUD in nulliparous women is as safe and effective as in parous women.

Adolescent↗
PubMed1977

Translocated intra-uterine contraceptive devices and missing strings.

The incidence, clinical presentation, diagnosis, possible aetiology and methods of treatment of translocated intrauterine contraceptive devices (IUCDs) and 'missing strings' are described. Details of 104 such patients, treated at Baragwanath Hospital over a period of 12 months, are given. Four unusual sites of translocation are described.

Adolescent↗
PubMed1997

The Nova-T 200 intrauterine contraceptive device: a 12 year study.

AIM: To evaluate the long term clinical performance of the Schering Nova-T 200 intrauterine contraceptive device. METHOD: From 1982 to 1990, 446 women were fitted with their first Nova-T IUD's and followed up until December 1994. By this cut off data, 21 (4.7%) were lost to follow up. These were excluded to simplify analysis. RESULTS: Of the remaining 425 women, there were 383 multipara and 42 nullipara. Thirty one percent were fitted with a new Nova-T after 4 years of use. The method was uncomplicated in 70% of multiparous women, but in nulliparous users, the removal rate for unacceptable bleeding and/or pain was found to be 40% compared to 19% for the multipara. An expulsion rate of 4.9% was recorded. The overall cumulative accidental pregnancy rate was 3.5% with a Pearl Index of 1.2 per hundred woman years, a lower rate in older users being the only age related event in the study. Possible pelvic inflammatory disease was recorded in 2.8% with a Pearl index of 0.96. There was no evidence of subfertility after removal in any of the 53 women where a pregnancy was desired. CONCLUSION: The Nova-T 200 IUCD is safe and cost effective and should continue to be offered as a contraceptive option for properly selected women. Although poorly tolerated by nullipara, it proved to be very satisfactory for multiparous women, particularly nursing mothers and those over 40 years of age.

Adult↗
PubMed1989

Clinical performance of a levonorgestrel-releasing intracervical contraceptive device during the first two years of use.

One-hundred-and-ninety-eight women used a levonorgestrel-releasing intracervical contraceptive device (LNG-ICD) designed to release 20 micrograms levonorgestrel/day. Clinical performance during the first two years of LNG-ICD use was evaluated. A total of seven pregnancies occurred during the study period, all of them during the first year. Six pregnancies were after unnoticed expulsion of the device. One pregnancy occurred in an epileptic women using carbamazepine, with the LNG-ICD remaining in situ. Eighteen spontaneous expulsions occurred, 16 during the first year and 2 during the second year. Three pelvic infections were observed, all of them during the first year. Bleeding problems, hormonal side effects and other medical reasons were the most common side effects resulting in removal of the device. The continuation rate was 72.6 per cent after one year and 57.1 per cent after two years.

Female↗
PubMed1981

Coagulation factors in women using oral contraceptives or intrauterine contraceptive devices immediately after abortion.

The changes in coagulation parameters were studied in 24 women who started using microdose combined oral contraceptives immediately after first-trimester abortion. Another 24 women who had an intrauterine contraceptive device inserted at the end of the abortion procedure were studied as control subjects. In pill users, a slightly increaed tendency toward hypercoagulability was observed 1 week after abortion in terms of elevated fibrinogen and Factor VIII as well as decreased antithrombin levels. Other studies have shown that the new follicle development after first-trimester abortion starts beyond the first week. It would therefore seem that by postponing oral contraceptive use until 1 week after abortion, no decrease in the effectiveness of contraception occurs and the possible risks of hypercoagulabilty during the postabortal period can be avoided.

Abortion, Induced↗
PubMed1992

Genital tract infections associated with the intrauterine contraceptive device can be reduced by inserting the threads into the uterine cavity.

OBJECTIVE: To study the influence of the position of the threads of an intrauterine contraceptive device (IUCD) on the development of genital tract infection. DESIGN: A multicentre randomized controlled trial. SUBJECTS: Women requesting an IUCD. INTERVENTIONS: The women were randomized to be fitted with an IUCD either with the threads contained in the uterine cavity (threads-up group) (n = 208) or passing through the cervix to the vagina in the usual way (threads-down group) (n = 237). Multiple centre study with follow-up at three months, 1 and 2 years. At the final visit 'missing' threads were retrieved using a disposable instrument (Retrievette). MAIN OUTCOME MEASURES: The occurrence of infection in the lower or upper genital tract. RESULTS: 63 women in the threads-up group and 78 in the threads-down groups dropped out. Previous gynaecological infection was reported by 21 and 48 women in the threads-up and threads-down group, respectively (odds ratio 0.44, 95% CI 0.24 to 0.79), 21 and 53 subjects had signs of infection at gynaecological examination (odds ratio 0.39, 95% CI 0.21 to 0.69) and a wet-smear was pathological in 33 and 79 (odds ratio 0.38, 95% CI 0.23 to 0.61). In the threads-up group the vaginal pH was also lower at the final check up after 2 years. Spontaneous descent of the threads occurred in 11% of the threads-up group and in six women in the threads-down group the threads were in the cervix. In 93 women the threads were easily retrieved by means of the Retrievette, four women insisted on the threads remaining in the uterus and in 18 thread removal was performed under local or general anaesthesia. CONCLUSIONS: Infectious complications in women using an IUCD are more frequent if the threads lead from the uterine cavity to the vagina. This problem can be reduced by inserting the threads so that they remain entirely within the uterine cavity, a feasible procedure now that an effective instrument for IUCD thread retrieval is available.

Adult↗
PubMed2004

Factors influencing discontinuation of intrauterine contraceptive devices: an assessment in the Indian context.

Sociocultural and behavioral factors are associated with decision to use and the selection of a contraceptive method, continuation of use and reasons for discontinuation of a contraceptive. This paper tries to distinctly outline the determinants of discontinuation of the intrauterine contraceptive device (IUCD), especially in the Indian context. Data on medical reasons for discontinuation are available through clinical trials. However, sociodemographic studies provide one with a wider spectrum to analyze the factors associated with the discontinuation of IUCDs. Information on service providers can be used to improve the quality of family planning services in the country. In India, a thorough review of birth spacing methods, especially the IUCD, is needed since the surveys show a high rate of discontinuation. The emphasis in this paper is upon compilation of reasons for discontinuation of the IUCD and research thereof. The review of the literature is directed towards giving a new direction to assessment of family planning programs, especially in India where population control is largely dependent upon permanent methods. Delineation of factors is important to improve the family planning program.

Contraception Behavior↗
PubMed1977

Absence of hCG-like activity in the blood of women fitted with intra-uterine contraceptive devices.

Blood was obtained at various stages of the menstrual cycle from 201 women fitted with intra-uterine contraceptive devices (IUDs), and plasma levels of hCG were determined by radioimmunoassay. Urine samples were obtained from 117 of these women and tested, before and after sephadex gel filtration, in a haemagglutination inhibition test for pregnancy (Pregnosticon). Plasma hCG was undetectable (less than 25 MLU/ml) in all but one of the 201 women and, in this instance, the hCG-assay appeared to be measuring a midcycle peak of LH, as evidenced by high plasma FSH levels. All unextracted urines gave negative results in the Pregnosticon test but, after extraction, 18 of the 117 urines gave positive reactions, most of these being from women at midcycle or in the luteal phase. We conclude that the IUD does not permit the development of the embryo to a point where it is capable of secreting measurable amounts of hCG. Recent claims to the contrary are probably due to cross-reaction of LH or non-specific interference in the assays used for measuring hCG.

Adolescent↗
PubMed2005

Intrauterine contraceptive device appendicitis: a case report.

Uterine perforation is one of the serious complications associated with use of the intrauterine contraceptive device (IUD). Uterine perforation by IUD can involve several neighboring organs. A case of acute appendicitis was caused by a Multiload Cu 375 IUD inserted previously. This is a rare complication and only fourteen previous cases were recorded in the literature.

Acute Disease↗
PubMed2001

Fetal death associated with asymptomatic intrauterine Candida albicans infection and a retained intrauterine contraceptive device.

We present a case of intrauterine fetal death at 18 weeks of gestation associated with a retained intrauterine contraceptive device and asymptomatic intraamniotic and fetal infection by Candida albicans. The infection was verified by histopathologic examination of the placenta and umbilical cord, growth of C. albicans in samples of amniotic fluid and the presence of high levels of IL-6 in the amniotic fluid.

Adult↗
PubMedDate not supplied

Histochemical study on the activity of some oxidative and hydrolytic enzymes in the normal human endometrium blood vessels and at various intervals after applying the intra uterine contraceptive device.

The paper intends to study the cytoenzymological modifications of the human endometrium blood vessels after applying the intrauterine contraceptive device for a long period of time. The results were different according to the: type of the enzyme-ATP-ase, Lactatdehydrogenase, Leucineaminopeptidase, NADH2-citochrome-c-reductase, the components of the blood vessel wall (intima, media, adventitia), the blood vessel diameter, the hormonal cyclic stage.

Adenosine Triphosphatases↗
PubMed1983

Factors associated with actinomyces-like organisms on Papanicolaou smear in users of intrauterine contraceptive devices.

To determine the factors associated with the presence of actinomyces-like organisms on cervicovaginal Papanicolaou smears in users of the intrauterine contraceptive device (IUD), we carried out a case-control study. Among about 80,000 Papanicolaou smears examined in one year in a large cytology laboratory, actinomyces-like organisms were identified on 107 smears; all but three smears were from IUD users. Compared with IUD users who did not have actinomyces-like organisms on Papanicolaou smears, those with actinomyces-like organisms had used the IUD for more years. An increased risk of actinomyces-like organisms on Papanicolaou smear was not apparent until 7 years of IUD use, however. No significant association of actinomyces-like organisms with the type of IUD was found after controlling for differences in duration of use between users of various IUDs. The percentage of women reporting gynecologic symptoms (vaginal discharge, pelvic pain, abnormal bleeding) also did not differ significantly between IUD users with and without actinomyces-like organisms on Papanicolaou smear (p = 0.5).

Actinomyces↗