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At least 1,207 records · Page 67Linked to original sources
PubMed2000

Prevalence of enlarged ovarian follicles among users of levonorgestrel subdermal contraceptive implants (Norplant).

OBJECTIVE: The aim of this study was to determine the prevalence of enlarged follicles, as detected by a single clinical or ultrasonographic examination, among users of levonorgestrel subdermal contraceptive implants (Norplant implants). STUDY DESIGN: This was a cross-sectional study of 103 users of Norplant implants and 50 users of the TCu380A intrauterine contraceptive device, all of whom received reproductive health services from PROFAMILIA, Santo Domingo, Dominican Republic. Bimanual pelvic examination and vaginal ultrasonography were performed. Enlarged follicles (>25 mm) were followed up weekly. The chi(2) test was applied to these data. RESULTS: Enlarged follicles were detected by ultrasonography in 17. 5% of Norplant implants users and 4% of TCu380A intrauterine contraceptive device users, respectively (P <.04). There was no difference according to duration of use. The longest time to involution of the follicles was 4 weeks. Forty percent of the enlarged follicles detected by ultrasonography were also detected by bimanual pelvic examination. CONCLUSION: Enlarged follicles are a frequent finding among women who use Norplant implants, but they are less frequent than described in previous studies, which were based on serial ultrasonographic scans in selected groups of users. Physicians and users should be aware of the transient nature of these enlarged follicles, which do not require intervention.

Contraceptive Agents, Female↗
PubMed1983

Actinomyces in the female genital tract. A preliminary report.

Actinomyces spp were isolated by culture of endocervical specimens from two groups of women attending the department of genitourinary medicine of the Royal Hallamshire Hospital, Sheffield. The first group consisted of 78 users of intrauterine contraceptive devices (IUCD) of whom 20 (25.6%) were culture positive. The second group contained 63 women using various forms of contraception 12 (19%) of whom were culture positive. None of these 12 women had an IUCD or foreign body in situ. The results suggest that Actinomyces spp may be part of the commensal flora of the genital tract in some women.

Actinomyces↗
PubMedDate not supplied

Characteristics of women who stop using contraceptives.

A relatively new multivariate life-table technique has permitted the effect of socioeconomic characteristics on first-year contraceptive failure rates to be determined to a greater degree of precision than was possible in the past. This technique is employed in this article to determine the one-year rates of contraceptive discontinuation among currently married U.S. women, using data from the 1973 and 1976 National Surveys of Family Growth (NSFG). The results indicate that poor women, black women and younger women are all relatively more likely to stop using contraceptives for reasons other than method-switching or the desire to become pregnant, as are women who have not completed high school, Catholic women and those who have never had a birth. Of all methods, the IUD is associated with the lowest rate of discontinuation. Pill users over age 30 are more likely to stop using their method than are comparable women using the IUD, diaphragm or condom. Women relying on spermicides are generally most likely to cease using a method. Finally, the subgroups of women who are most likely to stop using a particular method also are generally the groups that are most likely to experience contraceptive failures, while those that are least likely to discontinue use are also least likely to fail. Two exceptions are women who rely on rhythm and those who use the pill. The former experience relatively high rates of failure but are relatively less likely to stop using the method, and the latter have relatively high rates of discontinuation despite a low rate of failure.

Adolescent↗
PubMed2002

[Hydronephrosis in course of actinomycosis of female reproductive organs].

OBJECTIVES: Pelvic actinomycosis is a chronic suppurative granulomatous disease caused by an anaerobic Gram positive germ, Actinomyces. The most difficult task was to obtain the diagnosis in a patient with an intrauterine device and poor general health, signs of infection and a pelvic syndrome. RESULTS: This is a report of a case of hydronephrosis in course of actinomycosis of female reproductive organs in a patient aged 46 years with the intrauterine contraceptive device admitted to The Department of Gynecology & Obstetric in Hospital of Słupsk. Symptoms were presented as an acute abdomen associated with painful epigastric and mass in right adnexa. A pre-operative diagnosis of the right hydronephrosis, on ovarian tumor and uterus myoma were detected which lead to an extensive and difficult surgery. The pathologic process infiltrated the retroperitoneal space simulated sarcoma or lymphoma. The disease was serious and required hysterectomy with salpingo-oophorectomy and intra-abdominal drainage. Actinomycosis was confirmed by the postoperative histopathologic examination, and the patient was successfully treated with penicillin. The patient was completely free of symptoms two months within the operation. CONCLUSIONS: In patients who have intrauterine contraceptive devices or who have had them removed recently, abdominal pain, recurrent vaginal bleeding or adnexal masses should prompt a thorough search for potentially pathogenic actinomyces in the genital tract.

Actinomycosis↗
PubMed2003

A comparison of two adjunctive treatments for intrauterine adhesions following lysis.

OBJECTIVES: To assess which treatment modality has a better outcome: the use of an intrauterine contraceptive device or the Foley catheter balloon, for the adjunctive treatment of intrauterine adhesion (IUA) in patients presenting with infertility. METHODS: In a 4-year initial period, patients with intrauterine adhesion were treated with the insertion of an intrauterine contraceptive device (IUCD) after adhesiolysis. In the next 4 years, a pediatric Foley catheter balloon was used after adhesiolysis instead of the IUCD. The postoperative treatment was the same throughout the 8 years. While the IUCD was removed after three consecutive withdrawal vaginal bleedings, the Foley catheter was removed after 10 days. Hysterosalpingography was repeated in all patients after the third withdrawal vaginal bleeding, and the procedure was repeated if the intrauterine adhesion still persisted. The chi2-test was used for analysis. RESULTS: There were 51 cases of IUA treated with the IUCD and 59 cases treated with the Foley catheter balloon. In the Foley catheter group, 81.4% of the patients had restoration of normal menstruation compared with 62.7% in the IUCD group (P<0.05). Persistent posttreatment amenorrhea and hypomenorrhea occurred less frequently in the Foley catheter group (18.6%) than in the IUCD group (37.3%) (P<0.03), and the conception rate in the catheter group was 33.9% compared with 22.5% in the IUCD group. The need for repeated treatment was also significantly less in the Foley catheter group. CONCLUSION: The Foley Catheter is a safer and more effective adjunctive method of treatment of IUA compared with the IUCD.

Adult↗
PubMed2006

Intravesical migration of levonorgestrel-releasing intrauterine system (LNG-IUS) with calculus formation.

The intrauterine contraceptive device (IUD) has been in use for many years as an effective means of birth control. Migration of the device from the uterus to the pelvic cavity is not uncommon and has been reported previously, however intravesical migration and secondary calculus formation is relatively rare. We report a 28-year-old woman in whom an intrauterine contraceptive device (LNG-IUS) migrated from the uterus to the bladder and resulted in stone formation. This case shows that the newer hormone releasing IUDs may also cause bladder perforation.

Adult↗
PubMed2004

Attitudes of Israeli gynecologists towards the levonorgestrel-releasing intrauterine system: a questionnaire survey.

OBJECTIVES: The aim of the study was to examine the current attitudes and practices of gynecologists regarding the use of the levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena, Schering AG, Germany) as a contraceptive device and for the treatment of menorrhagia in the premenopausal period. In addition, physician knowledge of patient satisfaction with the device was evaluated. METHODS: A written, self-administered questionnaire was given to 300 gynecologists actively employed in gynecological departments and outpatient clinics in urban centers in Israel. The items covered the indications for which the LNG-IUS was prescribed, the estimated rate of use of the LNG-IUS compared to copper intrauterine devices (IUDs), patient satisfaction with the LNG-IUS and previous knowledge about it, and demographic characteristics of the population using IUDs. All forms were completed on an anonymous basis. RESULTS: The questionnaire was returned, properly completed, by 298 physicians, yielding a response rate of 99.3%. Almost one-half of the physicians (n = 147, 49.3%) used the LNG-IUS only as a contraceptive device, 17.4% only as treatment for menorrhagia, and 33.2% for both indications. The vast majority of gynecologists (82.2%) reported a patient satisfaction rate of 70% or more. Among the gynecologists using the LNG-IUS as treatment for menorrhagia, the estimated overall patient satisfaction rate was more than 50%. Although most physicians expressed greater patient satisfaction with the LNG-IUS than with copper-releasing IUDs (p < 0.004), the majority of gynecologists still used the copper-releasing IUDs more frequently. Most considered the LNG-IUS as an appropriate method for endometrial protection in postmenopausal women using estrogen replacement therapy. CONCLUSIONS: Physicians should be made aware of the beneficial health effects of the LNG-IUS, particularly in premenopausal women with menorrhagia and for endometrial protection during hormone replacement.

Adult↗
PubMed1984

[Low-carat gold intrauterine device for contraception 44 years in the uterus].

We report on a patient who retained a low-carat gold IUD in her uterus for 44 years. The IUD, which may have been hand-made, has one long and one short arm. The long arm lays within the uterine cavity and the short arm protruded from the cervical canal. The intrauterine device was inserted prior to the second World War. Since she tolerated it well, the patient did not seek regular medical check-ups. At 80 years of age, she complained of lower abdominal pain and the IUD was removed. The patient is suspected to have an ovarian tumor.

Aged↗
PubMed1991

Intra-uterine Candida infection: a report of four infected fetusses from two mothers.

Although Candida albicans is a frequent inhabitant of the female genital tract, chorioamnionitis is rarely caused by this fungal organism. In this report we present two cases with manifest Candida chorioamnionitis. The first case is a twin pregnancy with premature delivery and survival of both twins. The second case is a pregnancy with intra-uterine contraceptive device in situ ending in a midtrimester abortion, followed by the next pregnancy also ending in an abortion in the second trimester. Possible triggers responsible for the increased invasiveness of otherwise benign Candida vaginitis are discussed. Foreign intra-uterine bodies such as contraceptive devices and cerclage sutures necessitate repetitive search for Candida species infection, and prompt adequate antifungal treatment in cases of documented infection. Both cases of the present report add further substantial evidence to the hypothesis of amniotic infection by ascending transcervical infection. The frequent concomitant cervical infections with other infectious agents as well as antibiotherapy influencing the normal Lactobacillary defence mechanisms are both likely to increase the risk. Systemic debilitating diseases that promote invasiveness are briefly discussed.

Adult↗
PubMed1989

Causes of the increase in the incidence of ectopic pregnancy. A study on 1017 patients from 1966 to 1985 in Turku, Finland.

The relationship between the increased incidence of ectopic pregnancy and the known risk factors of this disorder was examined by 5-year age groups and equivalent calendar periods to determine the causes of the recent "epidemic" of ectopic pregnancy. None of the known risk factors would alone explain the observed increase. Consequently, multivariate analysis by log-linear models was applied: age, past pelvic operation, previous pelvic inflammatory disease, antecedent legal abortion, and current use of an intrauterine contraceptive device were responsible for the increase in the occurrence of the disease. The strongest association with the observed temporal trend in the increase of ectopic pregnancy was found for pelvic operation (including previous ectopic pregnancy), pelvic inflammatory disease, and current use of an intrauterine contraceptive device. Improved diagnosis and changing demographic patterns also contributed to the increase in the annual number of ectopic pregnancies.

Adult↗
PubMed2000

Endometrial lysosomal enzyme activity in ovulatory dysfunctional uterine bleeding, IUCD users and post-partum women.

The aim of this study was to evaluate the role of lysosomal enzymes in excessively heavy menstruation by comparing women with menorrhagia due to dysfunctional bleeding or intrauterine contraceptive device (IUCD) use with those with normal menstrual periods or with amenorrhoea associated with breastfeeding. This was a prospective cohort investigation of the activity of four endometrial lysosomal enzymes in three contrasting groups: (i) women with ovulatory dysfunctional uterine bleeding and users of intrauterine contraceptive devices; (ii) breastfeeding post-partum women in whom there are long periods of amenorrhoea, particularly in the early months post-partum; and (iii) normal cycling women. It was found that the total activity of lysosomal enzymes, particularly acid phosphatase and N-acetyl-beta-D-glucosaminidase, was markedly elevated (P < 0.001) in IUCD-exposed endometrium, and endometrium from women with dysfunctional uterine bleeding when compared with endometrium from women with a history of entirely normal menstrual periods or that in post-partum breastfeeding women. The activity of alpha-L-fucosidase was moderately elevated in IUCD users (P < 0.05) and ovulatory dysfunctional uterine bleeding (P < 0.05), whereas alphaD-mannosidase activity was elevated in ovulatory dysfunctional uterine bleeding (P < 0.05), but decreased in IUCD users (P < 0.01). No significant differences were observed in the lysosomal enzyme activities of breastfeeding post-partum women and normal cycling women. These results show that total endometrial tissue activity of four lysosomal enzymes was substantially increased throughout the cycle in most circumstances in women with two different causes for increased menstrual bleeding. This suggests a contributory role to the increased bleeding.

Acetylglucosaminidase↗
PubMed1999

Perceived gynecological morbidity among young ever-married women living in squatter settlements of Karachi, Pakistan.

BACKGROUND: Community-based information on obstetric and gynecological morbidity in developing countries is meager and nearly non-existent in Pakistan. OBJECTIVES: To estimate the prevalence of specific gynecological morbidities and investigate the predictors of pelvic inflammatory disease. METHODS: Users [404] and non-users [313] of modern contraceptives were identified from eight squatter settlements of Karachi, Pakistan and detailed information on basic demographics, contraceptive use, female mobility, decision-making and gynecological morbidities were elicited. RESULTS: The perceived prevalence of menstrual disorders were 45.3%, uterine prolapse 19.1%, pelvic inflammatory disease 12.8% and urinary tract infection 5.4%. The magnitude of gynecological morbidity was high with about 55% of women reporting at least one gynecological morbidity though fewer [20%] reported at least two gynecological morbidities. Significant predictors of pelvic inflammatory disease were intrauterine contraceptive device users (OR = 3.1; 95% CI 1.7-5.6), age < or = 20 years (OR = 2.3; 95% CI 1.1-4.8) and urban life style (OR = 2.1; 95% CI 1.0-4.6). CONCLUSION: There is an immense burden of reproductive ill-health and a significant association between ever users of intrauterine contraceptive device and pelvic inflammatory disease. We therefore suggest improvement in the quality of reproductive health services generally, but specifically for family planning services.

Adolescent↗
PubMedDate not supplied

Social marketing of contraceptives in Bangladesh.

Since 1975 there has been a family planning program operating in Bangladesh which advertises and commercially distributes contraceptive products in both rural and urban areas throughout the country. The program, known as the Social Marketing Project (SMP) and managed by Population Services International (PSI), now serves almost 1 million acceptors per month at an annual cost per couple of less than US$6.50, including the cost of donated contraceptives. This paper looks at the evolution of the project and its growth through the years, and addresses some primary concerns of planners of social marketing programs.

Advertising↗
PubMed2000

[Actinomycosis of the sigmoid colon as the etiology of lower abdominal pain].

We report a case of abdominal actinomycosis in a young woman wearing an intrauterine contraceptive device. The patient presented with right lower abdominal pain. A diagnostic laparoscopy was performed. Intraoperatively two perforations of the sigma were detected, a sigmoidectomy was performed. Postoperatively no problems occurred. Histology revealed an abdominal actinomycosis. In the literature only some case reports are published dealing with abdominal actinomycosis. Women wearing intrauterine contraceptive devices seem to have a higher risk of actinomycosis. In unproblematic cases antibiotic therapy is the treatment of choice. In cases of doubt as in our case surgery is recommended to confirm the diagnosis.

Abdominal Pain↗
PubMed1984

Contraceptives and acute salpingitis.

In 546 women with a first episode of salpingitis, the degree of inflammation of the fallopian tubes, as seen during laparoscopy, was graded into mild, moderate, and severe. The patients were subgrouped according to contraceptive use into (1) reference group (women not using intrauterine [contraceptive] devices [IUDs] or oral contraceptives [OCs]) (2) IUD group, and (3) OC group. Mild, moderate, and severe salpingitis occurred in 51.3%, 34.6%, and 24.1% of the women in the reference group. The corresponding percentages for the women in the IUD group were 54.6%, 29.7%, and 15.7%, and for the patients in the OC group, 73.5%, 17.1%, and 9.4%, respectively. Women using OCs had significantly milder degrees of inflammation of the fallopian tubes than women with other contraceptive methods. Age could not explain the differences.

Acute Disease↗
PubMed2000

Primary peritoneal pregnancy: a case report.

A 22-year-old primipara using intrauterine contraceptive device was diagnosed to be in haemorrhagic shock due to acute ruptured ectopic pregnancy. At laparotomy, both tubes and ovaries were normal and products of conception were found to be implanted on the posterior surface of uterus near the attachment of right uterosacral ligament producing a haemoperitoneum of more than 2 l. This is the fourth case report of primary abdominal pregnancy associated with intrauterine contraceptive device (IUCD).

Adult↗
PubMed1976

The role of the intrauterine device in contraceptive practice.

Recognition of the rarity of systemic complications of IUD's as compared with oral contraceptives, has increased the acceptability of the IUD. Improvements in the design of IUD's and increased experience in their use have resulted in extension of the range of women to whom IUD's can be offered. Points of practical management are discussed.

Abortion, Induced↗