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At least 127 records · Page 7Linked to original sources
PubMed2001

Emergency contraception with Multiload Cu-375 SL IUD: a multicenter clinical trial.

The objectives of the present study were to evaluate the efficacy and side effects and the benefits and limitations of inserting Multiload intrauterine device (IUD) for emergency contraception. A total of 1013 women requesting emergency contraception was recruited, among whom 843 were parous women and 170 nulliparous women. Multiload Cu-375 SL IUD was inserted within 120 h after unprotected intercourse. A urine test for pregnancy was performed before IUD insertion to rule out pregnancy. Participants were followed-up until 1 week after the expected day of the next menstruation. Pregnancy test or ultrasound scanning were performed if menstruation did not return. Efficacy of preventing unplanned pregnancy was calculated. Efficacy and side effects were compared between the parous and nulliparous groups. The results showed that there were two pregnancies, one in each group. The pregnancy rate was 0.2 per 100 women. The efficacy rate of preventing unwanted pregnancy in the parous group was 98.1% and in the nulliparous group 92.4%. The difference was not significant. Removal of IUD because of pain and bleeding was 2.5% in parous women, but was more in the nulliparous group (10.6%). After the return of menstruation, 95.7% of parous women and 80% of nulliparous women maintained the IUD for contraception. There were two complete expulsions and three partial expulsions of the IUD, but there was no significant changes in menstruation and bleeding pattern, nor was infection or trauma observed. It was concluded that IUD insertion is a safe and effective method for emergency contraception for both parous and nulliparous women. One of the advantages of using an IUD is its long-term contraceptive effect, if the women prefer to continue its use.

Contraceptives, Postcoital↗
PubMed1983

A clinicopathological study of IUD users with special reference to endometrial patterns and endometritis.

A group of 65 IUD users was studied during a period of 165 years of use, with a mean of 2.6 +/- 1.7 years per woman. The main complaint which differed significantly from the 120 controls was the occurrence of spotting in 33.8% of IUD users. Normal endometrial mucosae were found in 36.9% of IUD users and 38.7% of controls. Chronic endometritis was evidenced in 35.4% of IUD users versus 12.5% of controls; the former were asymptomatic in 25.0% of the cases. 39.1% of them had normal endometrial synchrony. Chronic endometritis occurred 2.2 +/- 1.3 years after insertion of the device. Endometritis was always symptomatic in controls; only 13.3% of them exhibited endometrial synchrony. The fundamental mechanism(s) responsible for the contraceptive efficiency of intrauterine contraceptive devices (IUD) remains a subject of controversy and a field of investigation. The most recent studies are essentially directed towards the biochemical analysis of uterine fluid [1]. Nevertheless, the presence of an inflammatory process, either morphologically or biochemically detectable, seems to be one of the fundamental modifications induced by the IUD. Since a certain reluctance to use IUDs has been observed in some countries, which has been ascribed mainly to contradictory reports on the risk of pelvic inflammatory disease (PID) in women wearing such devices [2], we found it interesting to intend to objectivate and reevaluate the influence of IUD on chronic aspecific endometritis, a possible precursor state of salpingitis and PID.

Adult↗
PubMed2006

[Weight variation in users of the levonorgestrel-releasing intrauterine system, of the copper IUD and of medroxyprogesterone acetate in Brazil].

BACKGROUND: Assess weight variations in Brazilian users of the 20 microg/day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena) for comparison with a cohort of users of the TCu 380A intrauterine device (IUD) and a cohort of users of the injectable contraceptive, depot-medroxyprogesterone acetate (DMPA) over a period of five years. METHODS: A total of 163 users of the LNG-IUS, who had the device inserted in 1998, were admitted to the study. At the time of enrollment, each woman was matched by weight (+/- 1 kg) and age (+/- 1 year) to a woman using a TCu 380A IUD and to another woman using DMPA. All women were followed up for a period of five years. Each year weight was measured and the body mass index (BMI, kg/m2) was calculated. RESULTS: Age of the LNG-IUS users was 27.0 +/- 6.7 years (mean +/- SD), while age of the copper IUD users was 28.0 +/- 6.6 years and that of DMPA users was 26.9 +/- 6.5 years. Weight recorded at the onset of the study was 62.9 +/- 0.8 kg, 62.8 +/- 0.8 kg, and 62.5 +/- 0.9 kg (Mean +/- SD) for users of the LNG-IUS, the copper IUD, and DMPA, respectively. The BMI of women was initially 25.0 (+/- 0.3), 26.4 (+/- 0.3), and 25.5 (+/- 0.4), (Mean +/- SD), for users of the LNG-IUS, copper IUD, and DMPA, respectively. Weight increases of 3.1 kg, 4.9 kg and 8.2 kg were observed at the end of the fifth year among users of the LNG-IUS, copper IUD, and DMPA, respectively (p = 0.009). Increase of the BMI was also observed among all groups (final BMI was 26.3 +/- 0.7, 28.5 +/- 0.8 and 28.7 +/- 1.3 for users of the LNG-IUS, copper IUD and DMPA, respectively). Multivariate analysis showed that there was a significant association between weight increase and length of use of the contraceptive method and of the DMPA. CONCLUSION: The use of a LNG-IUS during five years caused no significant weight increase and the difference in weight was of the same magnitude as that of copper IUD users.

Adult↗
PubMed1984

IUD-associated hospitalization in less developed countries.

Data on 11,977 insertions of an intrauterine device (IUD) from 25 collaborating centers in 16 less developed countries (LDCs) were investigated for IUD-associated hospitalizations. These centers maintained regular follow-up and reported at least one hospitalization among their IUD cases. The Lippes Loop, Copper T, Delta Loop, and Delta T were the most commonly used devices, and three-fourths of all devices were inserted in postpartum women. Fifty-five of the 128 reported subsequent hospitalizations were associated with IUD use. Main indications for IUD-associated hospitalizations were pelvic infection, bleeding/pain, and method failure. Statistically significant differences were not detected in the three-month gross cumulative rates for hospitalizations due to IUD complications by age (less than 30 vs 30+), parity (0-1 vs 2+), or device type (Lippes Loop and Copper T vs Delta devices vs others). Three types of IUD-associated hospitalization rates were calculated, each involving a margin of error: 1) a Pearl rate of 8.0 per 1,000 woman-years of IUD use; 2) a one-year life table rate of 6.3 per 1,000 insertions; and 3) crude rates ranging from 3.2 to 4.6 per 1,000 cases.

Adult↗
PubMed1986

A solution to the problem of "missing" IUD threads.

A disposable, plastic, sterile instrument, RetrievetteR, for the retrieval of 'missing' threads of intrauterine contraceptive devices (IUD) at routine gynecological investigations was developed and tested in 80 patients. In 64 instances, the threads were found and easily drawn out through the cervical canal. In the remaining 16 cases, where the threads were not found, this was due to already expelled IUD in 6, too short threads in 5, inverted IUD in one, IUD which had partly perforated the uterine wall in one, unknown factors in 2 cases where the women chose to keep a correctly placed IUD in spite of missing threads and, finally, in only one case due to method failure. In the latter case, a correctly placed IUD with threads of normal length was later extracted under general anaesthesia. It is concluded that this instrument can help the physician avoid more complicated and unpleasant procedures with ultrasonic or X-ray localization and subsequent IUD extraction under local or general anesthesia in women with missing IUD threads.

Equipment Design↗
PubMed1998

[Comparison of family physicians' and gynecologists' use of the intrauterine device (IUD)].

OBJECTIVE: To quantify differences between general practitioners (GPs) and gynaecologists in the technique of insertion and follow-up of the intra-uterine device (IUD). DESIGN: Multicentred, descriptive, longitudinal study. SETTING: Two urban health centres and a family guidance clinic. PARTICIPANTS: Target population (n = 1700) between January 1993 and January 1996. Estimated mean of complications was 25%. Sample size was 247 for alpha = 0.05 and 1-alpha = 0.95. The sample was extended to 300 to allow for possible losses of files, estimated at 20%. MEASUREMENTS AND MAIN RESULTS: The variables age, sex, marital status, educational level, parity, abortions, previous contraception, type of job, type of IUD, post-insertion and follow-up complications, subjective evaluation, removal and average follow-up time, were analysed. 158 (54.9%) of the 288 IUDs finally studied were inserted by GPs, and 130 (45.1%) by gynaecologists. 69.5% were anchor-shaped, and 30.5% T-shaped. In 85.5% no immediate complications were found. Mean follow-up time was 22.67 months (CI 95%, 21.3-24.0), during which time 36.6% had complications detected, which led to removal of the device in 22.3% of complications. We found no statistically significant differences between the two populations for age, marital status, subjective evaluation, number of abortions, parity or previous contraception. Likewise, no differences between G.P.s and gynaecologists were detected for post-insertion or follow-up complications, percentage of IUDs removed, or period of time evaluated. There were differences found for the type of IUD used, with more anchor-shaped IUDs in primary care. There were no differences for the type of IUD or complications requiring its removal. CONCLUSIONS: In the population studied we found no differences in immediate or later complications between IUDs inserted by GPs and by gynaecologists.

Adult↗
PubMed1983

[Release of copper ions after insertion of VCu200 IUDs].

In order to understand the life span of VCu200 IUDs in situ, the copper-ion concentrations in the cervical mucus were assayed after insertion of VCu200 IUDs for 5 years. Copper-ion concentrations were measured at random in 30 cases each of 1, 3, 6, and 12 monthth VCu 200 IUD users and 20 cases each of 24, 36, 48, and 60 month users. At the same time, 10 cases of the inserted-ring users were similarly studied for comparison. In addition, to obtain the normal copper-ion concentrations in the cervical mucus during the proliferative phase (8th-9th day), mid-period phase (10th-14th day) and the secretory phase (20th-23rd day) of a norma cycle, 16 cases of nonusers were selected as control. The measurements were assayed by a non-flame atomic absorption spectrophotometer. Samples of 0.2-0.4 gms of cervical mucus were collected in a glass tube from the IUD users on the 20th-23rd day of the menstrual period. There is a significant difference between VCu200 IUD users and nonusers (p 0.01) and ring users (p 0.01). The copper-ions released in VCu200 IUD users in different months were 2.61, 1.98, 1.96, 1.82, 1.22, 1.20, 1.15, 0.98 ug/g. w. w., respectively. The equation for regression line is y = -0.2764x+2.2340, which shows that the amount released decreased wtih increased time interval. However, the released amount of copper-ions at the end of 60 months was still higher in the users than in the nonusers (p 0.05). These results indicate that VCu200 IUDs can be left in situ at least 5 years without decreasing its biological activity in contraception.

Chemical Phenomena↗
PubMed1992

Hysteroscopic findings in complicated and non-complicated IUD users.

The hysteroscopic findings in 100 IUD users have been evaluated. 50 women had no IUD-related problems and requested removal of the device, while the other 50 complained of either bleeding and/or pain or lost strings. Of the 29 cases with IUD-related bleeding and/or pain, hysteroscopy revealed malposition (n=6), partial expulsion (n=3), partial perforation (n=2), embedding (n=1), or disproportion (n=6). Disproportion presented as crumpling of the device in the uterine cavity or protrusion of the tip of the transverse arm inside the tubal ostia. Endometrial lesions were also more commonly seen in the study group than the control group, i.e., endometrial hyperplasia (n=8), endometrial polyps (n=8), intrauterine adhesions (n=5), and submucous fibroids (n=2). Of the 21 IUD patients with missing strings, there were previous failed trial of blind removal in 11 cases. Most lost IUDs were found inside the uterine cavity (81%) with curling and ascending strings. Partial perforation, abdominal translocation, and unnoticed complete expulsion were detected in 19% of the patients. Direct visualization of the endometrial cavity is invaluable in treating IUD users who complain of pain and/or bleeding and in locating and retrieving missing IUDs.

Africa↗
PubMed1987

Mineral deposits formation in bioactive IUD's.

Mineral organic deposits have been observed in inert IUDs. The authors studied the presence of these deposits in bioactive IUDs. Inert, progesterone, and copper-releasing IUDs were removed at 12,24, and 36 months postinsertion. When the devices were cut between their vertical (body) and horizontal (arms) branches, both parts were processed independently. After laxly bound organic material was eliminated, the devices were extracted at 60 degrees Celsius for 90 minutes with 3N HC1, and finally all undissolved material was dissolved in 1N NaOH. In each fraction, protein and inorganic ions were measured. Mineral organic deposits were formed in all types of IUDs. The deposits increased with time in utero in a characteristic device-dependent pattern. The deposits were essentially made of proteins, sodium, and calcium ions and were higher on the inert Lippes Loop D (7.0 +or- 2.4 mg proteins; 2.8 +or- 0.85 mg calcium, and 0.138 +or- 0.048 mg sodium/device); less in the copper IUD (5.7 +or- 1.36 mg proteins, 0.89 +or- 0.12 mg calcium, and 0.180 +or- 0.046 mg sodium/device at 24 months); and even less in the progesterone-releasing IUDs (1.6 +or- 1.3 mg protein, 0.235 +or- 0.028 mg calcium, and 0.262 +or- 0.063 mg sodium/device).

Calcium↗
PubMed1992

Postpartum IUDS: keys for success.

Intrauterine device (IUD) insertion is convenient and efficient in the postplacental and immediate postpartum periods. Insertion at these times is demonstrably safe, having a low incidence of infection, few bleeding problems, and low perforation rates. IUD expulsion rates can vary widely, and are a function of timing of insertion, type of IUD, and insertion technique. When a copper T device is inserted postplacentally or immediately postpartum by an experienced and trained clinician, expulsion rates of about 7-15 per 100 users at six months can be expected. Women must be told how to detect expulsions and instructed to return for reinsertion or for another method. Most investigators emphasize that high fundal IUD placement will reduce the expulsion rate. Unplanned pregnancy rates for postplacental IUD insertion range from 2.0-2.8 per 100 users at 24 months when using modern copper IUDs, correct insertion technique, careful postinsertion instructions and good follow-up. Postplacental insertions are performed manually or with a ring forceps. Immediate postpartum insertions (10 minutes to 48 hours after delivery) are performed with the ring forceps.

Contraception↗
PubMed1996

Evidence against tailstrings increasing the rate of pelvic inflammatory disease among IUD users.

A meta-analysis was conducted to determine whether the presence of an IUD tailstring is associated with increased rates of pelvic inflammatory disease among IUD users. Included were seven clinical studies that compared the same IUD with and without a tail, and fifteen clinical studies that compared two similar copper IUDs that differed in the polymer used for the tailstring (polypropylene versus polyethylene). No increase in PID rates was found among users of IUDs with versus without a tail (RR = 1.2, 95% confidence interval 0.6-1.7), or among users of copper IUDs with different tailstring materials (polypropylene vs. polyethylene, RR = 0.9, 95% confidence interval 0.4-1.5). These findings support the hypothesis that the presence of a tailstring does not increase the rate of PID among users of IUDs.

Adolescent↗
PubMed1985

[Histochemical changes in endometrial fibrolytic activity with different IUDs].

The histochemical changes of endometrial fibrinolytic activity were observed in rabbits. 1 horn of the uterus was put in IUDs made of different materials (steel, copper, magnet, and EACA-copper). It was found that the endometrial fibrinolytic activity in the experimental horns was significantly higher than the controls, and the effect was the highest with the copper IUD. In the contrasted groups (copper versus steel, copper versus magnet, steel versus magnet), the endometrial fibrinolytic activity induced by the copper IUD was the highest (P0.05), while there was no significant diffeence between that of steel and magnet (P0.05). In the EACA-copper IUD groups, the results were also observed on days 7, 14, and 28 after insertion of the devices. There was no difference in fibrinolytic activity between the experimental horns and the controls in 7 and 14 days groups, but it was significantly higher than the controls in 28 days group. In the contrasted groups of the EACA-copper IUD and copper IUD the endometrial fibrinolytic activity of the former was lower than that of the latter in 7 days group (0.05 P 0.1). This suggests that fibrinolytic activity may be inhibited by EACA, which, however, may be released from IUD at such a rapid rate that it loses its effect in 28 days.

Animals, Laboratory↗
PubMed1996

Detailed analysis of menstrual bleeding patterns after postmenstrual and postabortal insertion of a copper IUD or a levonorgestrel-releasing intrauterine system.

Detailed information on the menstrual bleeding patterns in users of copper-releasing intrauterine devices (IUDs) and levonorgestrel-releasing intrauterine systems (IUSs) is lacking. Even less is known about the menstrual bleeding patterns associated with postabortal insertion of IUDs. We postulated that the scarcity of IUD studies including detailed analysis of bleeding could be a result of the lack of an easy-to-use computer program designed for this purpose. We therefore developed a set of graphical user interface (Windows) programs for entering, editing, and analyzing menstrual diary data. With these programs, we reanalyzed the menstrual diaries of the subjects of one of the hospital clinics that participated in a previous multicenter study comparing copper IUDs and LNg IUSs. The group included patients who had the IUD inserted postabortally. Copper IUD users had patterns of bleeding that were stable over time, and clearly more bleeding than LNg IUS users, many of whom had either infrequent bleeding, bleeding completely replaced by regularly occurring spotting, or amenorrhea. Postabortal insertion of LNg IUSs was associated with slightly better patterns of bleeding than postmenstrual insertion. Detailed statistics on bleeding help clinicians in counseling patients regarding these methods. The statistics permit assumptions to be made about the probabilities of specific menstrual disturbances and their changes over time.

Abortion, Induced↗
PubMed1996

Clinical experience with today's IUDs.

Today's IUDs are an extremely safe and effective method of contraception. The progesterone-containing system is associated with diminished menstrual blood loss; however, it must be removed and reinserted annually. The copper-containing IUD is effective for up to 10 years, and is protective against ectopic pregnancy. When used for at least 18 months, the copper IUD is the most cost-effective of all contraceptive methods available in the U.S. (37). There are low rates of adverse events associated with IUD use, with no systemic metabolic effects. There is a rapid return to previous fertility, comparable to other contraceptive methods, including oral contraceptives. In addition, in the event that a woman does become pregnant when using an IUD, the IUD does not increase the risk of congenital abnormalities. Finally, when inserted into appropriate candidates, there is a low risk of pelvic inflammatory disease.

Contraindications↗
PubMed1982

Management of uterine adhesions with 'Massouras Duck's Foot' and 'Butterfly' IUDs.

The Massouras Duck's Foot (MDF) IUD and the Butterfly IUD have been clinically evaluated. The MDF, which is Y-shaped, has 2 or 3 horizontal arms on a vertical stem and 2 triangular wings, in between the 'V'. When inserted after curettage, it prevents intrauterine or intracervical adhesions. The fan-shaped Butterfly IUD has 2 overlapping wings, thereby facilitating adjustment of the IUD to variable uterine cavities. Its wing span occupies the entire uterine cavity when inserted according to the instructions. Both IUDs are made of polyethylene plastic with barium sulfate. Several substitutions for barium sulfate are suggested, e.g., copper, silver, hormones, biodegradable polymers. The high antifertility action of these IUDs is due primarily to their occupancy of the entire uterine cavity.

Chemical Phenomena↗
PubMed1982

Hematologic characteristics in IUD users.

Increased uterine bleeding has often been cited as a frequent side effect of IUD usage. Previous reports have consistently linked IUD usage to increased menstrual blood loss; however, the role of the IUD as an etiologic agent in the development of iron deficiency with or without anemia is still unclear. This study examines hematologic and menstrual parameters in 52 IUD subjects and 40 control subjects. 90% of subjects with an IUD reported an increase in the amount and duration of menstrual flow and 35% noted intermenstrual bleeding. However, in a group of healthy women, the use of an IUD was not associated with significant or detrimental changes in common hematologic parameters.

Age Factors↗
PubMed1977

[Perspectives of ultrasonic diagnosis for the localization of intrauterine pessaries. Ultrasonic presentation of various types of IUDs].

The authors report on their experiences with ultrasonic localization of several types of IUDs. The investigations were carried out with the ultrasonic equipment-B-scanning -- Vidoson S 635 (Siemens). The characteristics of the echosonic pictures of 6 IUDs (Szontágh-IUD, Lippes-Loop, Gravigard, Alza-T, Copper-T, Antigon were studied. It could be stated that the IUDs can be well identified by ultrasonics. In cases of IUD in situ and early pregnancy the amnion and the IUD can be exactly localized.

Amnion↗
PubMed1975

IUD-related hospitalizations. United States and Puerto Rico, 1973.

In a mail survey of physicians likely to be involved with intrauterine contraception in the United States and Puerto Rico, 49.2% of the physicians responded, describing 3,502 unduplicated reports of hospitalizations related to the use of intrauterine contraceptive devices (IUDs) during the first six months of 1973. We estimate from this response that approximately 7,900 IUD-related hospitalizations occurred during that period. Interviews with a probability sample of nonrespondents demonstrated that their IUD complication experience was not substantially different from that reported through the mail survey. Estimates of the number of IUDs worn in 1973 permit rate calculations of three to ten IUD-related hospitalizations per 1,000 woman-years of IUD use. The rate of hospitalizations attributable to the IUD is probably higher that that attributable to combination oral contraceptives.

Adolescent↗