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PubMed1976

Induced illegal abortions in Benin City, Nigeria.

Abortions of all types constitute about 25% of our gynaecological admissions. In 8 months period between July 1974 and February 1975, 59 patients admitted into our unit with confirmed illegally induced abortions were studied personally by the author. It was found that most patients with this type of abortion were single, young schoolgirls. Most of the patients were 12 weeks pregnant or more at the time of the attempted termination. Most of the people who carried out these 'operations' by instrumentation were usually unskilled personnel. The complications in these patients which included one death are discussed. It is concluded that sex education including the use of contraceptive devices will help in reducing the high incidence of this 'social evil'. It is also thought that the liberalization of abortion laws in this country will also be helpful in reducing the complications associated with induced abortions.

Abortion, Illegal↗
PubMed1978

Unification of a septate uterus: Mahgoub's operation.

A simple surgical technique for unification of a septate uterus is described. The septum and a small strip of fundus are removed with scissors inserted through two small fundal stabs, and the opening is closed with one mattress suture, which forms an anteroposterior suture line no more than 1 cm long. At the end of the operation an intrauterine contraceptive device is inserted to prevent uterine adhesions. The operation has several advantages: (a) it leaves a capacious uterine cavity of normal appearance, (b) it avoids large uterine incisions, and thus the possibility of postoperative adhesions or weak uterine scars, and (c) it avoids possible injury to the cornual ends of the Fallopian tubes. This article reports favorable results in 17 women treated with this surgical technique.

Abortion, Habitual↗
PubMedDate not supplied

Bilateral tubal pregnancy in the presence of an IUD: a case report.

Bilateral tubal pregnancy was confirmed by histologic examination in a 32-year-old multipara with an intrauterine contraceptive device (IUD) in situ. The patient had developed intraperitoneal bleeding and hypovolemic shock. Bilateral salpingectomy was performed and was followed by a rapid recovery.

Fallopian Tubes↗
PubMedDate not supplied

Bacteriologic study of IUDs removed from Nigerian Igbo women.

Intrauterine contraceptive devices (IUDs) removed from 50 Igbo women were subjected to bacteriologic studies. High vaginal swabs from the women were cultured simultaneously. In 49 of the 50 IUDs, the culture was negative. The author concludes that the African IUD wearer, like her Caucasian peer, can safely combat any bacterial nidus introduced during device insertion.

Adult↗
PubMed1992

Polypropylene IUCD retrieval fibers: surface morphology, material properties, microbial attachment, and migration.

Highly drawn and oriented polypropylene fibers used for the retrieval thread of the Cu-7 intrauterine contraceptive device (IUCD) are compared as to surface morphology and crystallinity with polypropylene fibers prepared under different conditions. A series of experiments also demonstrates the colonization of the surface of polyolefin fibers by pathogenic bacteria that are often found in the human vagina. Moreover, it is demonstrated that the retrieval threads appear to encourage pathogenic bacteria to migrate across the surface of agar. The results also indicate that control of drawing and annealing can avoid the surface fibrillation and tendency to fail by separation into a bundle of multifilaments that are observed with the IUCD retrieval threads.

Bacteria↗
PubMed2000

Computed tomography guided core needle biopsy diagnosis of pelvic actinomycosis.

BACKGROUND: Pelvic actinomycosis is a chronic suppurative inflammatory disease caused by the anaerobic Gram-positive bacilli Actinomyces israelii. The propensity of this disease to simulate gynecological malignancies has been described previously. The great majority of these patients were diagnosed with actinomycotic diseases during or after exploratory laparotomy, but rarely preoperatively. We reviewed the literature pertaining the management of pelvic actinomycosis. CASE: A nulliparous woman with a long history of intrauterine contraceptive device (IUD) and recent Papanicolaou smear findings consistent with the presence of actinomyces presented with chronic vague lower abdominal pain, weight loss, poor appetite, and recent increase in abdominal girth associated with a large immobile pelvic mass. Transcutaneous computed tomography guided core needle biopsy established the diagnosis of pelvic actinomycosis obviating immediate surgical intervention. Intravenous and subsequent long-term oral penicillin therapy was constituted and resulted in a significant decrease in the size of the pelvic mass. CONCLUSION: In patients presenting with pelvic masses and a history of IUD placement, actinomycotic infection should be considered and diagnosis attempted by imaging guided needle biopsy. Furthermore, this case suggested that correct nonsurgical diagnosis of pelvic actinomycosis followed by prolonged antibiotic therapy might eliminate the need for extensive extirpative surgery and assist in maintaining future fertility.

Actinomycosis↗
PubMed1994

Increased 8-hydroxydeoxyguanosine in kidney and liver of rats continuously exposed to copper.

Copper is a ubiquitous metal in the environment, it is a component of dental casting gold alloys and dental amalgams, and it is a main component in some intrauterine contraceptive devices (IUDs). Since copper materials implanted in the human body corrode and release ions into the surrounding tissue, the potential toxicity caused by contact of this metal with bodily fluids needs to be evaluated. We implanted male Wistar rats with osmotic mini pumps that continuously administered saline, CuCl2, or a copper chelate, cupric nitrilotriacetate (Cu-NTA), at a rate of 4 mg copper/kg body wt/day. This experimental design maintained serum copper concentrations at a level 30-70% (CuCl2) or 100-120% (Cu-NTA) higher than in untreated controls. At different times postimplantation, we measured the levels of 8-hydroxydeoxyguanosine (8-OHdG) in DNA of kidney, liver, and tissue surrounding the pump implant, since production of 8-OHdG has been associated with mutagenesis and carcinogenesis. Hepatic and renal levels of 8-OHdG in CuCl2- or Cu-NTA-treated animals were significantly higher than in control animals. In contrast, histopathologic changes in kidneys and livers of rats exposed to CuCl2 and Cu-NTA were limited to mild changes involving hepatic focal necrosis and slightly increased mitotic activity in the renal proximal tubules. These observations suggest that levels of 8-OHdG could be an early marker of copper toxicity. It is unlikely that the high levels of copper at which we observed DNA modification will be encountered after occupational or environmental exposure. A different situation could be found around medical devices that include copper, particularly IUDs, where the amount of copper administered in our experiments could be released in the uterus of women after a few months of continued IUD use.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed1995

Colonic actinomycosis: report of a case and review of the literature.

Abdominal actinomycosis is a rare entity which presents some difficulty in establishing a correct preoperative diagnosis. We report herein the case of a 41-year-old woman who developed abdominal actinomycosis involving the left colon and the surrounding retroperitoneum. The patient, who had an intrauterine contraceptive device (IUCD) in situ, presented with left flank pain and the signs and symptoms of an intraabdominal mass, which was initially diagnosed as a neoplasm originating from the left colon or the retroperitoneal space. Thus, a left colectomy was performed, but the histopathological pathological diagnosis revealed abdominal actinomycosis. We evaluated the diagnosis and treatment of this disease in light of the knowledge acquired from the available literature on this rare entity.

Actinomycosis↗
PubMed1978

Discriminative control of the vaginal vasomotor response.

With use of a discriminative control procedure and operant techniques, women significantly increased their vaginal pulse amplitude (produced vaginal vasodilation) but did not significantly decrease vaginal pulse amplitude (produce vaginal vasoconstriction). Acquisition of vaginal pulse amplitude control was rapid with no significant improvement over trials or the 5 experimental days. Specificity of vaginal pulse amplitude control occurred in relation to the other vasomotor responses, including vaginal blood volume and digital pulse amplitude. Vagnial pulse amplitude changes were not related to somatic-muscular, respiratory, or heart-rate changes. Women who used oral contraceptives were better able to control vaginal pulse amplitude than women who used other forms of birth control. Although the sexual behavior of these two groups and did not differ, women in the latter group tended to be more clitorally oriented.

Adolescent↗
PubMed1985

Cefotaxime in the treatment of female pelvic soft tissue infections.

Forty-six females with pelvic soft tissue infections (recurrent salpingitis [n = 14], salpingitis with intrauterine contraceptive device [IUD] [n = 9], salpingitis with adnexal mass [n = 14], post-partum endomyoparametritis [n = 9]) were randomized for three antibiotic treatment regimens: cefotaxime (CTX) (n = 23), clindamycin and gentamicin (C + Gen) (n = 13), and clindamycin, gentamicin and penicillin (C + Gen + P) (n = 10). Patients were evaluated by diagnosis for clinical response to the three regimens and by pre-treatment bacterial susceptibility to the individual as well as the combination antibiotics. All 14 recurrent salpingitis patients responded satisfactorily to the assigned antibiotic regimen (CTX, n = 8; C + Gen, n = 3; C + Gen + P, n = 3). One of four patients with the diagnosis of salpingitis/IUD treated with CTX was a treatment failure, while three of three patients treated with C + Gen and two of two patients with C + Gen + P responded satisfactorily. Two of three patients with the diagnosis of salpingitis/adnexal mass failed therapy with C + Gen while the seven patients treated with CTX and the four patients with C + Gen + P responded satisfactorily. All nine patients with endomyoparametritis responded to their treatment regimen. Overall, there were no statistically significant differences in the responses by diagnosis and regimen, with the exception that C + Gen was significantly different (p less than 0.05) from CTX and C + Gen + P for the treatment of salpingitis with mass. Of the 141 bacterial isolates in all groups, 57 were aerobic or anaerobic gram-positive organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗
PubMed1985

Comparison of three multiload IUDs: MLCu250, MLCu375 and MLAgCu250.

A comparative study was made of three differently loaded Multiload intrauterine contraceptive devices. The IUDs were used by 450 women for 3 years unless the device was removed earlier. The reasons for IUD removal (pregnancy, bleeding and/or pain, and other) were recorded, and the data analyzed after 1 year and after 3 years using the log-rank method. No statistically significant differences could be found among the three devices either in rate of pregnancy nor IUD removal for any reason.

Adult↗
PubMed1986

Comparative performance of two copper IUDs: Nova-T and MLCu375.

A comparative randomized trial was made of two intrauterine contraceptive devices: Nova-T and MLCu375. The IUDs were used by 637 and 606 women, respectively, for one year, unless the device was removed earlier. The reasons for IUD removal were analyzed after one year using the life-table method. Statistically significant differences were found in expulsion and removal for bleeding and/or pain rates.

Adolescent↗
PubMed1987

Does a gradually decreasing menstrual blood loss (MBL) in women wearing a Cu-IUD indicate a risk for an accidental pregnancy?

In three separate series, comprising 71 women using either a Gravigard, a Nova-T or a Multiload contraceptive device, the menstrual blood loss (MBL) was quantitatively assessed before and after insertion of each respective IUD. In three women, an involuntary pregnancy was registered with the IUD in situ. In these three women a successively diminishing MBL was registered during the last 3 months before conception, while none of the remaining women included in the series experienced any accidental pregnancy or any reduction of the MBL. Thus, this report emphasizes the potential risk for an accidental pregnancy in women wearing a Cu-IUD if successively diminishing MBLs are observed.

Adult↗
PubMed1988

Clinical results with the TCu340 IUD.

A trial was carried out on the TCu340 intrauterine contraceptive device. The IUD was used by 431 women over a period of 2 years. The reasons for IUD removal were analyzed after 1 and 2 years using the life-table method. Later, the authors compared these results with the MLCu375 and the Nova-T, using the coefficient Z of Cramer. The authors concluded that the TCu340 was a high-load IUD with high effectiveness. However, there was a higher incidence of side-effects, such as pain, bleeding and expulsion in comparison to MLCu375.

Adolescent↗
PubMed1987

Comparison of two copper IUDs: the MLCu375 and the Nova-T.

A comparative randomized trial was carried out on two intrauterine contraceptive devices: the Nova-T and the MLCu375. The IUDs were used by 1116 and 1237 women respectively, over a period of 2 years. The reasons for IUD removal were analyzed after one and two years using the life-table method. Statistically significant differences were found in the rates for pregnancy, expulsion and removal for bleeding and/or pain favoring the MLCu375 IUD.

Adolescent↗
PubMed1989

Postpartum IUD contraception--a review of an international experience.

Postpartum insertion of intrauterine contraceptive devices (IUDs) performed while women are still in hospital has a number of advantages. Earlier reports, however, generally associated this procedure with high expulsion rates. Recent studies, on the other hand, have shown that if IUDs are inserted immediately (within 10 minutes) after placental delivery, it is safe and effective. In some experienced centers, fairly low expulsion rates are reported. In this paper the experiences with postplacental IUD insertions from international studies are reviewed, the lessons we have learned from these experiences summarized, and future research directions suggested.

Cross-Cultural Comparison↗