[Experiences and observations of 80 women using the Spider Cu intrauterine contraceptive device for 2 years].
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Levels of progesterone, estradiol, LH, and FSH were measured in daily serum samples obtained from 4 subjects during a control cycle and during the first and fourth menstrual cycles after insertion of an intrauterine device (IUD). In addition, progesterone and estradiol were measured in serum samples obtained from 6 women 3, 4, or 5 months after IUD insertion, and from 6 women more than 1 year after IUD insertion. These measurements were compared to the data obtained from study of a large group of normal cycles. The results indicated that the IUD does not influence follicular maturation, time of ovulation, or corpus luteum function. The IUD did exert a local effect on the endometrium, causing the onset of menses to take place when steroid levels were higher than in control cycles.
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Pelvic inflammatory disease (PID) is one of the most commonly encountered serious infectious disease entities in gynecology. The past decade has witnessed many advances in our understanding of the pathogenesis of PID. It is now evident that such pelvic infections are largely polymicrobial in origin, with major involvement by anaerobic organisms. Salpingo-oophoritis is a part of the spectrum of PID. Included among this group of infections are tubo-ovarian abscesses, traditionally referred to as either gonococcal or non-gonococcal in origin. Within the latter group of infections the importance of anaerobic organisms has also been elucidated. Of particular interest is the reported observation of an increased frequency of salpingo-oophoritis among users of intrauterine devices (IUDs). These reports have noted the specific occurrence of serious pelvic infections due to Actinomyces species, and this will be the topic of the infectious disease conference. Our patient presented with a chronic illness characterized by lethargy, back pain, fever, and anemia; subsequently evaluation disclosed the presence of a large pelvic mass which was confirmed as a tubo-ovarian abscess at surgery. Histological evaluation demonstrated involvement by Actinomyces species. This patient's illness is discussed as a complication of chronic IUD usage with reference to specific management for this emerging problem.
From an indigent population hospitalized with acute salpingitis, 163 patients were compared with 222 control patients from the minor trauma section of the emergency room. Four factors were significantly different between cases and controls: race, type of contraception, number of sex partners, and previous history of salpingitis. A discriminate analysis based on a linear logistic equation demonstrated that each risk factor was independent rather than a reflection of another risk factor. Thus factors associated with race, IUD use, multiple sexual partners, and previous salpingitis increase the risk of salpingitis in the population studied.