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At least 649 records · Page 36Linked to original sources
PubMed2005

Serum and peritoneal fluid levels of levonorgestrel in women with endometriosis who were treated with an intrauterine contraceptive device containing levonorgestrel.

OBJECTIVE: To determine and compare levels of levonorgestrel (Lng) in serum and peritoneal fluid (PF) of patients on the Lng intrauterine system Mirena (Schering Health, Berlin, Germany) for endometriosis and to relate these to symptoms. DESIGN: Prospective clinical trial. SETTING: Gynecology unit of a teaching hospital. PATIENT(S): Women with minimal to moderate endometriosis at diagnostic laparoscopy. INTERVENTION(S): Mirena was inserted at diagnostic laparoscopy and blood and PF collected for Lng levels. Levonorgestrel was again quantified in serum at 1, 3, and 6 months and PF at 6 months. MAIN OUTCOME MEASURE(S): Serum and PF Lng levels during 6 months, differences in levels before and 6 months after Mirena insertion, and the relationship between these levels and symptoms of endometriosis. RESULT(S): There was significant improvement in symptoms after 6 months on Mirena. The mean (SD) serum Lng levels were 459.2 (100.2), 368.2 (51.8), and 357.3 (53.0) pg/mL at 1, 3, and 6 months, respectively. The PF levels at 6 months were approximately two-thirds the serum levels in patients showing improvement in symptoms. CONCLUSION(S): Mirena delivers significant amounts of Lng into the PF and serum. The relationship between Lng levels in these compartments is linear.

Adult↗
PubMed1997

A comparison of the clinical performance, contraceptive efficacy, reversibility and acceptability of Norplant implants and Ortho Gynae T380 intrauterine copper contraceptive device.

In this comparative study, the five-year continuity rate of 53.7% in the Norplant implants group was comparable to that of 52.7% in the copper IUD group. The difference was not statistically significant. Only one accidental pregnancy occurred during the five years of copper IUD use. Desire for future pregnancy was the main reason for removal in the Norplant implants group (35.9%) while expulsion of the IUD (13.2%) was the main reason for removal of the copper IUD. Menstrual disturbance was not a major side-effect in either group. The post-removal conception rates of 78.6% in the Norplant implants group and 75.0% in the copper IUD were good and comparable. Both the Norplant implants and copper IUD are acceptable and effective contraceptive methods in Singapore.

Adult↗
PubMed2000

The intrauterine contraceptive device.

The intrinsic appeal of the convenience and effectiveness of the IUD has increased interest in these devices in the United States in recent years. Understanding the uniqueness of the Dalkon Shield experience and applying the lessons learned about appropriate candidate selection should continue to reduce any lingering liability concerns. One lawsuit has been filed against the copper IUD in the 12 years that it has been available in the United States. If legislation requiring insurance coverage for IUDs and other prescription contraceptive agents continues to be passed by more states, the use of IUDs will continue to grow. The introduction of new IUDs with different side-effect profiles will expand the number of US women who can and will be interested in using this method of birth control.

Cost-Benefit Analysis↗
PubMed2001

Do we really know how to respond to an unexpected event during the fitting of an intra-uterine contraceptive device?

OBJECTIVE: To assess and improve knowledge of correct resuscitation procedures if an unexpected event occurs during an intra-uterine device (IUD) fitting. DESIGN: Previous literature on resuscitation in the family planning clinic was reviewed to provide a basis for a questionnaire for doctors and nurses within the service to assess knowledge of correct procedures. Outcome of first questionnaire: Seventeen questionnaires were returned in the first round, of which 12 were from nurses. The results to the first question gave a 70% correct response rate. The response to the second gave a correct response of 41%. Only six out of 17 would give atropine in a vaso-vagal attack. INTERVENTION: The results were discussed at an audit meeting and most staff said that they wanted further training. This was linked with the Leeds Community and Mental Health Trust training for resuscitation. By linking to this training programme it saved time and resources for the family planning service. Outcome of second questionnaire: Twenty-one staff returned questionnaires, of which 12 were nurses. The results to the first question gave an 87% correct response rate. The response to the second showed a correct response of 71%. Fourteen out of the 21 replying would give atropine. CONCLUSION: A service cannot assume that staff know what to do in an emergency if it is rarely encountered. This audit showed that it is possible to raise knowledge standards through a training programme.

Ambulatory Care Facilities↗
PubMed1982

Duration of breast-feeding and development of children after insertion of a levonorgestrel-releasing intrauterine contraceptive device.

IUDs releasing levonorgestrel, 10 micrograms per day (30 patients) and 30 micrograms per day (40 patients), and copper-releasing IUDs (Nova-T) (40 patients) were inserted six weeks after delivery in 110 breast-feeding amenorrheic women. The infants were carefully followed-up by recording monthly weight gain and growth, age of eruption of the first tooth, age of being able to walk without support and morbidity to infective diseases. No differences were noticed between the study groups. Plasma samples were collected from 13 children at the age of eight months, while the mothers were breast-feeding. Six mothers had a levonorgestrel-releasing IUD and seven others the Nova-T or no hormonal or intrauterine contraceptive. No differences were noticed between the groups in Na, K, Cl, Ca, P, protein, albumin, creatinine, urate, Fe, cholesterol, triglyceride, bilirubin, alkaline phosphatase, aspargine aminotransferase, alanine aminotransferase, lactate-dehydrogenase or high density lipoprotein cholesterol serum concentrations in the children. The duration of breast-feeding and initiation of supplementary feeding was recorded. The continuation of breast-feeding 75 days after the insertion of a 30-micrograms per day levonorgestrel-releasing IUD was 56 percent while in the Nova-T group only 21 percent had discontinued which is a statistically significant difference (p less than 0.05); later the difference disappeared. Compared with the lactation time of their previous breast-feeding reported by women in both groups, the present lactation time increased by ten weeks. The infants received substitute foods including substitute milk, juices, etc., in the Nova-T group at 3.9 months and in the levonorgestrel-releasing IUD group at 3.4 months after delivery.

Adolescent↗
PubMed1985

Intrauterine bone contraceptive device: an accident of nature.

Ultrasonography and hysterosalpingography led to discovery of four bony plates retained in the uterine fundus after an abortion 33 months earlier and which had apparently led to secondary infertility in a 26-year-old woman. Removal of the bony plates was soon followed by a successful pregnancy.

Abortion, Incomplete↗
PubMed1996

Immediate postpartum insertion of the norplant contraceptive device.

OBJECTIVE: To determine the safety and efficacy of Norplant (Wyeth-Ayerst Laboratories, Philadelphia, PA) insertion immediately postpartum. DESIGN: Prospective study of 14 women receiving Norplant immediately postpartum compared with controls (n = 6) having a bilateral tubal ligation. Subjects were followed for 3 months postpartum, and data were analyzed by analysis of variance and chi2. SETTING: Academic Health Sciences Center. PATIENTS: Female subjects 18 to 35 years old who had an uncomplicated term pregnancy, normal spontaneous vaginal delivery, and did not breast-feed. INTERVENTION: A brief interview, physical exam, and blood and urine samples were evaluated during a 12-week postpartum period. MAIN OUTCOME MEASURES: Major complaints, serum chemistry panels, hematologic and coagulative measures, serum E2, P, levonorgestrel, PRL, LH, FSH, and urinary estrone-3 conjugates and pregnanediol-3-glucuronide concentrations. RESULTS: Serum levonorgestrel peaked at approximately 2,000 pg/mL (6,400 pmol/L) during the 1st week after Norplant insertion, declining to approximately 250 pg/mL (800 pmol/L) by the 8th week. Significant differences between Norplant and control groups included bleeding irregularities, headaches, alopecia, and abdominal discomfort. Serum electrolytes, metabolic markers, and blood components were within normal limits. Serum E2, P, and urinary steriod biomarkers indicated that steroid secretion was suppressed severely in the Norplant group compared with controls who exhibited normal postpartum ovarian activity. CONCLUSION: Norplant inserted immediately postpartum appears to be a safe and effective method of contraception. However, the long-term hypoestrogenic state and contraceptive efficacy beyond the 3-month postpartum period as observed in this study are concerns that need further clinical evaluation.

Adolescent↗
PubMed1984

Pituitary and ovarian function and clinical performance during the use of a levonorgestrel-releasing intracervical contraceptive device.

A levonorgestrel-releasing intracervical device (ICD) was inserted postmenstrually to twenty-one voluntary women. Eight subjects gave blood samples twice a week during the initial three months of use of the ICD and during the seventh and twelfth months of use. Clinical performance was studied; plasma concentrations of levonorgestrel were measured by radioimmunoassay and the effects of the treatment on pituitary and ovarian function were determined by assaying plasma concentrations of LH, FSH, estradiol and progesterone. The results of the first year are presented. Dysmenorrhea, menstrual flow and the number of days of bleeding decreased during the first treatment year. Three spontaneous expulsions occurred; two at the very beginning of the treatment and one after six months of use. Side-effects were few. The plasma level of levonorgestrel remained fairly constant during the observation time of 12 months. Thirty-one of the 36 cycles were ovulatory as judged by plasma progesterone elevations. No pregnancies occurred during the study period of one year.

Adult↗
PubMedDate not supplied

Reduction of menstrual blood loss by naproxen in intrauterine contraceptive device users.

Eleven patients with objective evidence of menorrhagia (greater than 80 ml menstrual blood loss for two cycles) while fitted with an IUD were treated during three consecutive menstruations with the prostaglandin synthetase inhibitor naproxen. Menstrual blood loss was significantly reduced (p less than 0.001) from a pretreatment value of 131 +/- 12 ml to 88 +/- 9 ml on naproxen therapy. In the cycle following naproxen therapy, menstrual blood loss returned to the pretreatment level of 129 +/- 10 ml. Continued IUD usage was made more acceptable by naproxen therapy.

Blood↗
PubMed1977

Sonographic demonstration of intrauterine contraceptive devices.

Ultrasonic examination of the uterus is the investigation of choice in the initial localization of an IUCD within the uterine cavity. The use of compound B scanning in conjunction with A scans has been completely reliable to date. Radiography should be reserved for those patients in whom an expected device is not shown within the uterine cavity, and for those in whom the determination of the type of device is important and the scan is equivocal.

Adult↗