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PubMed1990

[Hemoglobin, serum iron and transferrin saturation among users of intrauterine devices and oral contraceptive agents].

We studied 60 females using either intrauterine device or taking oral contraceptive pills. Hemoglobin, serum iron, total iron binding capacity and saturation of transferrin were determined before and 4 and 10 months after starting a responsible paternity program. Women with a basal hemoglobin level below 12 g/dl were excluded. Age, parity and hematologic parameters were similar for both groups. A significant decrease in hemoglobin level and saturation of transferrin was observed at 10 months in intrauterine device users (13.6 to 13.1 g/dl and 36.2 to 26.9%, respectively). Use of oral contraceptive pills was not associated to hemoglobin decrease but a significant rise in saturation of transferrin was observed (36.2 to 43.9%, p less than 0.05).

Adult↗
PubMed2001

Mifepristone as a late post-coital contraceptive.

This study was undertaken to assess the efficacy of mifepristone as a post-coital contraceptive beyond 72 h and up to 5 days in women who found the intrauterine contraceptive device (IUCD) unacceptable. During a 2 year period 219 consecutive women fulfilling the inclusion criteria and presenting late for emergency contraception were approached and offered a choice of methods. Fifteen (6.8%) women wished to have the IUCD fitted, but 204 (93.2%) who found this unacceptable were offered and accepted mifepristone 200 mg. In one woman there was a technical problem fitting the IUCD and mifepristone was administered. Women who had mifepristone were younger (mean age 21.4 versus 26.9 years, P = 0.004) and more likely to be nulliparous (81 versus 25 %, P < 0.001) than the IUCD group. A total of 155 (75.6%) women who had mifepristone and all 14 who had the coil fitted were followed up. There were no true failures in either group. There was one user failure in the mifepristone group, where pregnancy occurred from an act of intercourse subsequent to treatment, giving a crude pregnancy rate of 0.65%. Mifepristone prevented 85% of expected pregnancies. Most women find the IUCD an unacceptable method of post-coital contraception. Mifepristone is an effective late post-coital contraceptive, which can be offered to women who decline the IUCD.

Adult↗
PubMedDate not supplied

Attitude towards family planning in Dharan, east Nepal: implications for the family planning programme.

A survey of the knowledge, attitude and practice of family planning was conducted in Dharan, Nepal. The town offers a full range of family planning services free of charge. There was a strong desire to limit family size; 52.5% of couples were currently using some modern method of family planning. Of the current users, 62.3% had been sterilized, including 92.3% of those in the lowest socioeconomic group. Health risks and incompleteness of the family were the most common reasons for non-use of contraception, the latter reason reflecting ignorance of the temporary nature of some methods. There was a strong preference for male children and couples rarely used contraception until at least one so had been born. Even in this prosperous town where couples were highly motivated towards family planning and all methods were readily available, there was heavy reliance on sterilization. This is typical of Nepal and has largely been responsible for the failure of the family planning programme--as most couples choosing sterilization are in the older age group and have completed a relatively large family. If Nepal is to succeed in meeting its target of reducing the total fertility rate (i.e., births per woman) from the current 5.8 to 4 by the year 2000 it will need not only to expand services but actively to promote temporary methods of contraception, particularly the more reliable longer acting reversible methods such as Depo-Provera, Norplant and intrauterine contraceptive devices.

Adolescent↗
PubMed1981

Contraceptive embarrassment and contraceptive behavior among young single women.

The purpose of this paper was to determine factors predictive of contraceptive embarrassment and to determine the relationship of contraceptive embarrassment to contraceptive use among young unmarried females. Contraceptive embarrassment was measured by an 8 item scale. Data were obtained from 265 nonvirgin high school and university females who were currently dating. Using simple multipe regression 30% of the variance of the embarrassment scale was explained, with the most important predictors being parental attitude toward premarital intercouse and sexual guilt. Other significant predictors were attitude to planning ahead to use contraception, perceived difficulty in obtaining contraceptive devices, and peer attitudes toward premarital intercouse. The embarrassment scale had significant correlations with contraceptive use.

Attitude↗
PubMedDate not supplied

Removal of completely perforating IUDs by explorative laparotomy.

Nine patients with completely perforating intrauterine contraceptive devices are presented. In all cases, the device was removed by explorative laparotomy. In eight out of the nine women, the device was found to be embedded in the omentum or vesical peritoneal plica. The advantages of explorative laparotomy over laparoscopy or colpotomy are emphasized.

Adult↗
PubMed1981

Haemostasis in menstrual endometrium in the presence of an intrauterine device.

The histology and ultrastructure of the haemostatic response in the endometrium have been studied in 12 uteri containing an inert or copper wound intrauterine contraceptive device (IUCD). The uteri were removed during the premenstrual phase or during the first 96 hours of menstruation. The results have been compared to earlier observations in non-IUCD influenced endometrium. In all uteri the tissue shedding proceeded more slowly in the presence of an IUCD and considerably fewer haemostatic plugs were found. The platelets in these plugs were more loosely packed and less degranulated, and the plugs contained less fibrin than in the absence of an IUCD. Haemostatic plugs were still observed at times when no such plugs were seen in uteri without an IUCD. Unoccluded vessel lesions were regularly seen and vessels open to the shedding surface were occasionally encountered. These observations suggest that IUCD-induced menorrhagia is caused by the combination of delayed shedding and a decreased haemostatic reaction in the endometrium.

Adult↗
PubMed1984

[Actinomycotic tubo-ovarian abscess in the presence of an intrauterine device].

Two cases of women with actinomycotic tubo-ovarian abscesses are reported. Both of the patients were users of intrauterine contraceptive devices. They were successfully treated by abdominal hysterectomy with salpingooophorectomy--in one cases appendectomy in addition--and pelvic drainage combined with antibiotic therapy. Aspects of nature, diagnosis, mode of infection and therapy of actinomycosis are discussed.

Abscess↗
PubMed1982

The effect of oral contraceptives on antiaggregatory prostacyclin and proaggregatory thromboxane A2 in humans.

The effect of different types of oral contraceptives on the productions of antiaggregatory prostacyclin (PGI2) and proaggregatory thromboxane A2 (TxA2) was studied by measuring the stable metabolites of these prostanoids, that is, 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) and thromboxane B2 (TxB2), respectively, from plasma. In addition, the capacity of the platelets to produce TxB2 during spontaneous clotting was studied by measuring the TxB2 levels from the serum incubated at +37 degrees C for 60 minutes. The material consisted of 48 women who had used estrogen-containing oral contraceptives for 2.0 +/- 1.9 years (mean +/- SD), 24 women using progestogen-only pills for 3.7 +/- 2.0 years, and 42 women of the same age using no oral contraceptives or intrauterine contraceptive device. The plasma concentrations of 6-keto-PGF1 alpha in women with combined oral contraceptives (65.5 +/- 16.1 pg/ml, mean +/- SD) was lower (p less than 0.01) than that in the control subjects (77.4 +/- 26.4 pg/ml), whereas the use of combined oral contraceptives was associated with no changes in TxB2 levels in plasma or serum, in women with progestogen-only oral contraceptives, the plasma levels of 6-keto-PGF1 alpha and TxB2 were normal, but the capacity of the platelets to release TxB2 during spontaneous clotting was decreased (113.6 +/- 77.6 ng/ml versus 179.9 +/- 81.9 ng/ml, p less than 0.05). In a prospective trial on 11 women, who started using 30 microgram of ethinyl estradiol and 150 microgram of levonorgestrel, no changes in PGI2 or TxA2 were seen during the first 3 months of usage. The decrease in antiaggregatory PGI2 during the prolonged use of estrogen-containing oral contraceptives may be associated with the increased risk of thromboembolism.

6-Ketoprostaglandin F1 alpha↗
PubMedDate not supplied

The risk of transmission of genital Chlamydia trachomatis infection is less than that of genital Neisseria gonorrhoeae infection.

A total of 211 men with 237 female sexual partners and a total of 155 women with 156 male consorts were examined for genital infection with Chlamydia trachomatis and Neisseria gonorrhoeae. The index patients had either single chlamydial or gonococcal infections or dual infections with both microorganisms. Analysis of recovery rates for groups of sexual consorts indicated that gonorrhea was contracted more frequently than chlamydial infection. Thus, when index patients had dual infections, 45% and 28% of their female and male consorts, respectively, had chlamydial infection, but 64% and 77%, respectively, had gonorrhea. When index patients had single infections with C. trachomatis or N. gonorrhoeae, chlamydial infections were observed in consorts of 45% (women) and 28% (men), but gonococcal infections were observed in 80% (women) and 81% (men). Moreover, a significantly larger proportion of consorts of patients with chlamydial infection eluded infection than did partners of patients with gonorrhea. Women who used an intrauterine contraceptive device had chlamydial and gonococcal infections more often than those who used other forms of contraception, or no contraceptive.

Adolescent↗
PubMed1994

Does maternal behaviour influence the risk of perinatal death in Jamaica?

Features of behaviour of mothers of singleton perinatal deaths collected over the 12-month period from 1 September 1986 to 31 August 1987 were compared with 9919 mothers of singleton infants born in September and October 1986 and surviving the first week of life, as part of the Jamaican Perinatal Mortality Survey. For perinatal deaths as a whole, and in the presence of maternal age and social and environmental features, logistic regression analyses showed that the following were independently related with higher risk of mortality: (1) deliberately trying to get pregnant; (2) ever having used Depo Provera; (3) not drinking alcohol in pregnancy; and (4) smoking cigarettes in pregnancy. There were no associations with coital frequency, ever using the contraceptive pill or smoking ganja (cannabis). Deaths were classified using the Wigglesworth scheme, and separate analyses carried out for the three major groups--antepartum fetal deaths, deaths from immaturity and deaths from intrapartum asphyxia. Antepartum fetal deaths were at increased risk if (1) mothers were deliberately trying to get pregnant or (2) they had ever used Depo Provera. Deaths from immaturity were not associated with any health behaviour variables. Deaths from intrapartum asphyxia were more likely if (1) the mother was deliberately trying to get pregnant or (2) she had never used an intrauterine contraceptive device.

Asphyxia Neonatorum↗
PubMed2006

What is it about intrauterine devices that women find unacceptable? Factors that make women non-users: a qualitative study.

INTRODUCTION: There is a lack of published research into the perceptions of 'non-users' of copper intrauterine contraceptive devices (IUDs). Despite this being one of the most commonly used methods of contraception in other countries, only 5% of contraceptive users in Great Britain aged 16-49 years currently use an IUD. This study explores how women's lay beliefs and perceptions about IUDs lead to rejection of this contraceptive choice. METHODS: One-to-one semi-structured interviews were conducted with 10 women of varying ages and parity recruited from an urban general practice. None of the women had ever used IUDs but all had used contraception in the previous 6 months. Data were subjected to qualitative analysis. RESULTS: Five analytical themes were identified: lack of objective information about IUDs, reported side effects of IUDs, anxieties about the process of fitting an IUD, IUDs as an infection risk and lack of personal control of an IUD, once fitted. CONCLUSIONS: Some of the themes identified mirrored those found in studies of user attitudes to and experiences of IUDs. Others, particularly the prominent worries about mess and embarrassment during fitting and the association between the hidden nature of the fitted device and unreliability, are new and need wider exploration.

Adolescent↗
PubMed1997

Interval and postabortal contraception with the frameless GyneFix.

Intrauterine contraceptive devices (IUDs) have not suffered from the same negative influences in the developing world as in the first world. The method has too many basic advantages to be gainsaid including, most importantly, that it has the lowest lifetime cost of any effective method of contraception, and that user compliance is not an issue once the device is in place. However, the global community is not immune from trends that are seen in selected industrialized countries. Today, better methods of contraception are requested and the discomforts associated with earlier models of IUD, which were once acceptable, are less so today. Faced with the side-effects of oral contraception and the high cost in developing countries, many women who have completed their families undergo surgical sterilization as the only long-term method available to them, notwithstanding severe cultural and economic reservations about doing so. The development of the frameless device is a response to the growing need to develop high-performing, long-acting, reversible and acceptable contraceptives with a high continuation of use and to respond to the urgent need to reverse the legacy of neglect of immediate postabortal family planning.

Abortion, Induced↗
PubMed1984

Pelvic infection: a comparison of the Dalkon shield and three other intrauterine devices.

A detailed analysis was undertaken of reports of possible pelvic infection in relation to the use of four commonly fitted intrauterine contraceptive devices during 1971 to 1978 in the United Kingdom. The four devices were the Dalkon shield, Lippes loops 3C and 2D, and the Gravigard (copper 7), and data used were those collected systematically through the UK intrauterine device research network. Prospective reports that the Dalkon shield was uniquely related to high levels of infection when compared with other intrauterine devices were not substantiated in this prospective study among 13 349 users. Though some factors such as social class and previous experience of abortion appeared to influence the rate of infection, the type of intrauterine device being worn did not appear to be a significant factor. Various methods of analysis were used including life table, regression, and discriminant analysis, using information relating to the type of intrauterine device worn, the characteristics of the user, the fitting centre, and the pattern of diagnosis and treatment of reported or suspected pelvic infection. The results of this study suggest that fears that the Dalkon shield may be associated with a higher incidence of pelvic infection than other intrauterine devices may have been unjustified.

Female↗
PubMedDate not supplied

Clinical performance of intrauterine device TCu-380 A in Benghazi, Libyan Arab Jamahiriya.

The study examined the reproductive and health profile of Benghazi women using intrauterine contraceptive devices (IUDs) and evaluated one such device, the TCu-380 A. An historical longitudinal study was carried out using data from the Fertility Regulation Clinic, Keish Polyclinic, Benghazi. The subjects were 457 women registered for TCu-380 A insertion between 1995 and 1998, who had been under follow-up for at least 6 months. The majority were Libyan (87.8%), aged 20-29 years (63.4%), of parity 1-6 (67.1%), non-lactating (64.3%) and with normal delivery at last conception (95.1%). Half had a chronic disease. The cumulative 36-month follow-up of those using TCu-380 A revealed an effectiveness rate of 99.8%, a continuation rate of 96.1% and complications in 3.5%. TCu-380 A appears to be an effective, durable and safe IUD.

Adolescent↗
PubMed1983

Risk of uterine perforation among users of intrauterine devices.

Since 1965 there has been a substantial increase in the number of women in the United States who use the intrauterine contraceptive device (IUD). A collaborative multicenter case--control study was conducted to examine uterine perforation and uterine incarceration as well as several other suspected complications related to use of an IUD. To determine which attributes of the IUD and which user characteristics contribute to the risk of uterine perforation and incarceration, the authors analyzed 32 women with uterine perforation requiring transperitoneal removal, 106 women with uterine incarceration of an IUD which was removed transcervically, and 497 controls. Most important, women who were lactating at the time of IUD insertion were 10 times as likely to have had a uterine perforation as women with at least 1 live birth but who were not lactating at the time of insertion. An incarcerated IUD resulting in a difficult removal was 2.3 times as likely among women lactating at the time of insertion compared to women not lactating at the time of insertion. The likelihood of both uterine perforation and uterine incarceration were unchanged regardless of the type of IUD used.

Abortion, Induced↗
PubMed1983

Ectopic pregnancy: a seven-year survey.

Seventy-five patients with ectopic pregnancy were treated at Jordan University Hospital (JUH) during a 7-yr period from January 1976 to December 1982. The ratio of ectopic pregnancies to deliveries was 1 to 162. The most common symptoms were: abdominal pain, 96%; amenorrhea, 69.3%; vaginal bleeding, 60%. No patients with pelvic inflammatory disease were found. An intrauterine contraceptive device was present in 14.6% of the patients and 10.6% of the cases had previous pelvic surgery. Culdocentesis gave false negative results in 16.7% of the patients. The treatment of choice was salpingectomy. There were no maternal deaths in this series.

Adolescent↗
PubMed1986

Contraception in diabetic women.

In diabetic women investigations have been performed covering the clinical consequences of intrauterine contraception and the influence on glucose and lipid metabolism of oral contraceptives. Insertion of copper-T intrauterine contraceptive devices in insulin-dependent diabetic women resulted in accidental pregnancy rates and total continuation rates after 12 months which were at the same levels as in non-diabetic women. No differences were observed in the maximum depth of corrosion or in the constitution of the corrosion products. The glucose tolerance as well as the serum lipoprotein levels remained unchanged when low-dose hormonal compounds were administered to women with a previous gestational diabetes. In insulin-dependent diabetic women it was found, that the use of oral contraceptives containing natural oestrogen may not give rise to difficulties with the diabetes control or disturbance in the lipid metabolism.

Adult↗