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[Diagnostic ultrasound and the intrauterine pessary].

The aim of the authors is an analysis of the results in application of ultrasound technique in patients with intrauterine device (IUD). Using the ultrasound criteria for a correct and incorrect position of IUD, the criteria for an elevated risk for expulsion and contraindications for IUD application, the authors have used ultrasound technique for diagnosis in 65 patients with IUD. The causes for the "wrong" diagnosis were discussed: imperfection of the apparatuses, non-observance of the conditions for ultrasound examinations and lack of experience. Practical conclusions and recommendations for an increase of the effectively of this seemingly easy method for diagnosis and follow-up of the IUD were made.

Diagnostic Errors↗

[Pregnancy with an intrauterine pessary in the placenta].

A case of a 23 year old patient which had become pregnant with a copper-T-IUD in situ is presented. After a pregnancy without many complications a healthy child was born. The copper-T-IUD was partially embedded in the placenta. Usually the delivery of a living and healthy child will not take place if a foreign body is situated in the placenta. If a woman becomes pregnant in spite of an IUD in situ, the IUD should be removed, even if this removal should terminate pregnancy. The risk of septic abortion in a pregnant woman with an IUD in situ is 1 in 15 to 1 in 30.

Congenital Abnormalities↗

[X-ray determination of the coincidence of intrauterine pessary and pregnancy].

It is reported on 21 pregnancies during contraception with IUD, among them one tubal pregnancy, one pregnancy with normal outcome and one pregnancy with a partly perforated IUD. By means of an extra- and intraamnial opaque matter injection one can find out exactly the position of the IUD on the roentgenogram before artificial abortion is carried out. The IUD can be seen above the small pelvis as a result of the changed position and the growth of the uterus during pregnancy. Furthermore it is possible to notice a glide down of the IUD into the cervix uteri or a perforation of the IUD into the uterine wall respectively into the pelvic cavity.

Adult↗

[The ultrastructural changes occurring in the endometrium of women who use intrauterine pessaries].

The authors studied ultrastructural changes in the endometrium of 25 women, using intrauterine contraceptive devices, preventing conception, during various time limits. The material of the endometrial biopsy was fixed with glutar and osmium in a phosphate buffer and embedded in durcopan. Section were prepared by a microtome and observed under electron microscope of Hitachi type. Comparing the parameters duration of usage of loops and character of changes in the endometrium an impression was obtained that the usage of contraceptive intrauterine devices for one-year period did not induced changes of pathological character. Functional changes in the endometrium occurred after a two-year stay of the loop in the uterus as there were inflammatory changes of spot-like character in two of the sections. Local areas of inflammation of nonspecific character, manifested under the form of lymphocytes and leucocyte accumulation, were found in women with long usage of contraceptive intrauterine devices. The authors advise to remove the loop 2.5-3 years after its application and to wait for the complete regeneration of the endometrium.

Endometritis↗

[Hysterographic follow-up of the results of treating uterine synechiae with an intrauterine contraceptive pessary].

The authors discuss the results from roentgenological (cervical hysterography) examination of the uterine cavity, aiming to confirm the results from the treatment of intrauterine synechiae. It was established that there were no roentgenological data for synechiae after the conducted treatment in 73.9% of the examined hysterograms. The treatment had no substantial effect only in 8.7% of women as synechiae remained unchanged. Very good results were obtained after usage of the intrauterine contraceptive devices--Super Dana and Lippes, possessing volumetric and stretching form in respect to the uterine cavity. The authors conclude that the hysterography is exact diagnostic method for confirming the effect of treatment of synechiae in the uterine cavity with suitable intrauterine loops.

Adult↗