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PubMedDate not supplied

Copper IUDs, PID, and fertility in nulliparous women.

Some authors have suggested that use of IUDs (intrauterine contraceptive devices) in nulliparous women should be contraindicated because of the risk for PID (pelvic inflammatory disease); others have found nulliparous women to be suitable candidates for IUD use. Clinical studies of copper IUDs in which parous and nulliparous women have been compared with regard to risk of PID often point to young age as a risk factor, regardless of parity. Vital statistics of PID rates also show this trend. An overall PID rate of 1.49/100 woman-years (WY) was calculated from data contained in 28 of the clinical studies reviewed in this paper. These studies included 25,674 women, of whom 42.5% were nulliparous. Studies of fertility following use of copper IUDs indicate that fertility is not impaired by their use.

Adolescent↗
PubMedDate not supplied

The CU SAFE 300 IUD, a new concept in intrauterine contraception: first-year results of a large study with follow-up of 1017 acceptors.

After more than a decade of basic research with the help of cavimetry, retentiometry, X-ray and ultrasonography, a new intrauterine contraceptive device, the CU SAFE IUD, was developed. The plastic body of the device shows the following properties: uterine cavity compatible, enhanced flexibility, low surface area, fundus-seeking anti-expulsive design, no anchoring mechanisms, and one monofilament without a knot embedded into the shaft. The copper surface area of 300 mm2 guarantees a high efficacy for up to five years. The CU SAFE 300 IUD fulfils all requirements of the International Organization for Standardization (ISO) in regard to intrauterine devices. This paper reports on the first-year results of a large ongoing CU SAFE 300 study, number of insertions 1150. 1017 acceptors of all fertile age groups accumulated 10,576 woman-months of use. The event rates were as following: pregnancy 0.6; expulsion 0.6; removal for bleeding 4.2, for pain 1.5; infection 0.0; other medical 0.9; non-medical 3.1. The continuation rate was 89.1 at the end of the first year. The increased safety and high efficacy of the CU SAFE 300 provides comfort for both user and partner. The ease of insertion without a plunger and gloves (inserter tube diameter 3 mm) and the ease of removal (force of traction approximately 1 N) mean safety also for the medical and paramedical fitter of the CU SAFE 300 IUD.

Female↗
PubMed1988

Mechanism of action of high-load copper IUDs.

A comparative study was made of four intrauterine contraceptive devices: the Nova-T, MLCu250 Short, MLCu375, and the Gyne T. An endometrial biopsy was performed on the 25th day of the menstrual cycle. The tissue obtained was analyzed to determine estrogen and progesterone receptor concentration. After two years of IUD use, both estrogen and progesterone receptors decreased proportionally to the increased amount of copper in the IUD.

Adult↗
PubMed1988

Histological reactions of human endometrium to the IUD.

A comparative study was made of four intrauterine contraceptive devices: the Nova-T, MLCu250 Short, MLCu375 and the Gyne T. An endometrial biopsy was performed on the 25th day of the menstrual cycle. The tissue obtained was analyzed to determine endometrial morphology patterns. After two years of IUD use, no inflammatory changes were demonstrated with MLCu375. Histological responses of the endometrium to the IUD depend on the amount of copper in the IUD.

Adult↗
PubMed1988

One-year results with the Fincoid IUD--a Hungarian experience with the short model.

This study presents the one-year experience with a new copper-releasing intrauterine contraceptive device, the Fincoid IUD. Between November 1984 and August 1985, 650 Fincoid devices were inserted in parous women to test the efficacy and clinical performance of the devices. After one year, 16 pregnancies had occurred (2.8 net cumulative rate); 26 devices had been partially or totally expelled (4.4); 27 devices had been removed for bleeding and/or pain (4.7); and 16 devices had been removed for other medical reasons (2.8). The continuation rate at the end of the first year was 84.3, indicating a good clinical performance.

Female↗
PubMed1995

Contraceptive use and reproductive history in women with cervical human papillomavirus infection.

The study was conducted to investigate whether cervical human papillomavirus infections (CHPI) are associated with contraceptive use and reproductive history. The contraceptive and reproductive histories in 972 women seeking contraceptive advice were noted and screening conducted for human papillomavirus infection. The interview included number of pregnancies and childbirths, legal and spontaneous abortions, and menstrual pattern. Information about current use of contraceptive methods, about casual sex, and history of combined oral contraceptive pill (OC) use was obtained. Women with a history of spontaneous abortion showed a significant correlation with CHPI, as did women who used high-dose OCs when compared with the remaining study population (odds ratio 3.0). There was no association between use of low-dose OCs and CHPI. In multifactorial analyses with adjustment for age, number of lifetime sexual partners, number of partners during the preceding six months and age at first intercourse, the significant correlation between use of high-dose OCs and CHPI remained (adjusted odds ratio 2.8). The results indicate a relationship between female steroid hormones and the occurrence of CHPI. An association with high-dose OCs could not be excluded.

Abortion, Induced↗
PubMed1985

The photochemical decomposition of the progestogenic 19-norsteroid, norethisterone, in aqueous medium.

Norethisterone, a contraceptive 19-norsteroid, was decomposed in aqueous medium (pH 7.4) by UV-B radiation (280-320 nm). This 4-en-3-oxo-19-norsteroid was not prone to the skeletal rearrangement reactions usually observed in steroids possessing a C10-methyl group. Under the reaction conditions applied, products were formed by addition of molecules, such as solvent molecules or a second steroid molecule, and by reduction of the double bond. The prevalence of addition type reactions may have consequences for the application of norethisterone-like steroids in subdermal contraceptive devices.

Norethindrone↗
PubMed1986

The effect of copper ions in vivo on specific hormonal endometrial receptors.

A comparative randomized study was made of three intrauterine contraceptive devices: the Nova-T, MLCu250 Short and MLCu375. An endometrial biopsy was performed on the 25th day of the menstrual cycle before and after IUD insertion. The tissue obtained was analyzed to determine estrogen and progesterone receptor concentration and endometrial morphology patterns in IUD users. Both estrogen and progesterone receptors decreased proportionally to the increased amount of copper in the IUD. The histologic study showed changes in endometria relative to the amount of copper, but these changes were transitory and disappeared after a year of IUD use.

Adult↗
PubMed1991

Cervical cancer and methods of contraception.

When evaluating whether the use of a particular method of contraception is associated with an increased or decreased risk of cervical cancer, it is important to be aware of the epidemiological factors which might lead to incorrect conclusions. After careful consideration of the issues, and examination of the available data, it is concluded that women who use oral contraceptives are possibly at increased risk of invasive cervical cancer; users of barrier methods probably have a decreased risk (although the protective effect may differ between the various types of barrier method); and that users of other methods of contraception do not have an altered risk.

Contraception↗
PubMed1991

Contraceptive use in young women: uptake, availability and education.

Despite increased availability of contraception and a relaxation of prescribing laws unplanned pregnancies will still occur. However when the right to life of the unborn child is enshrined in the constitution it is vital to provide adequate sex education and ensure the availability of all methods of contraception to reduce unplanned pregnancies to a minimum. This paper surveys the use of contraception prior to pregnancy in a group of unmarried mothers who delivered at a Dublin maternity hospital. It also surveys the availability of contraception from the pharmacies within the hospital's catchment area and the provision of sex education in the surrounding schools.

Adult↗
PubMed2006

[How safe is magnetic resonance imaging in patients with contraceptive implants?].

When patients with an implanted contraceptive device undergo MRI, it must be ensured that the examination involves no risk to the patient (MR safety) and that the diagnosis is not affected by artifacts or the function of the device compromised (MR compatibility). Two basic types of intrauterine devices can be distinguished: the metal-containing/metal-free intrauterine device (IUD) and the hormone-containing implant, the fully metal-free intrauterine system (IUS), as well as the ESSURE insert made of stainless steel, which has been approved for use in Europe since February 2001. The metal-containing and metal-free IUDs and ESSURE are MRI compatible up to a magnetic field strength of 1.5 T. They do not interact in any relevant way with the external magnetic or high-frequency field and the temperature increase is within the physiologic range. The implants merely produce a local signal void with a shape that depends on their orientation relative to the magnetic field lines. At 3 T, only the metal-free IUD and the IUS are MRI safe in terms of the material used. In contrast, metal-containing IUDs and the ESSURE have not yet been fully evaluated in the 3 T field, which is why they represent a contraindication to MRI. No data are available on the MRI compatibility at 3 T for any of these devices.

Burns↗
PubMed2005

The hormonal control of uterine luminal fluid secretion and absorption.

The secretion of uterine luminal fluid initially provides a transport and support medium for spermatozoa and unimplanted embryos, while the absorption of uterine luminal fluid in early pregnancy results in the closure of the lumen and allows blastocysts to establish intimate contact with the uterine epithelium. We have established an in vivo perfusion technique of the lumen to study the hormonal control of the events in the peri-implantation period. Fluorescein-labelled dextran was included in the perfusion medium to monitor fluid movements and the concentrations of Na(+) and CI(-) ions in the effluent were monitored. Using an established regimen of steroid treatment of ovariectomized rats mimicking early pregnancy, oestradiol caused fluid secretion, while progesterone resulted in an amiloride-sensitive fluid absorption. Fluid absorption peaked at about the expected time of implantation. The effect of progesterone could be inhibited by treatment with a high dose of oestradiol, by the anti-progestin RU486, and by the presence of an intra-uterine contraceptive device. Studies of expression of Na(+) and CI(-) channels (ENaC, CFTR) indicated that these channels were subject to tissue-specific regulation within the uterus, but more work is required to determine their role and the factors controlling their abundance and localization in early pregnancy.

Animals↗
PubMed2000

Efficiency of combined colonoscopy and computed tomography for diagnosis of colonic actinomycosis: a retrospective evaluation of eight consecutive patients.

The preoperative diagnosis of colonic actinomycosis is accurate in fewer than 20% of patients. Colonoscopy and computed tomography (CT) findings were analyzed to ascertain their diagnostic value and their role in determining therapeutic modality and outcome. Before and after treatment we retrospectively evaluated eight consecutive patients with colonic actinomycosis, all of whom were women with a previous history of intrauterine contraceptive device use. Median follow-up period was 20 months (7-57). Localized nodules were found in all cases by colonoscopy; half of these nodules included umbilication at the apex. The colonic mucosa demonstrated normal to moderate inflammation as well as hyperemia and edema. Mucosal ulceration was found in only one case. All cases showed some degree of stenosis. These findings differ from those in other inflammatory or neoplastic diseases of the colon. Abdominopelvic CT revealed extramural involvement of heterogeneous lesions all cases. Contrast enhancement also indicated severe thickening of the colonic wall (7-20 mm) with focal and dense enhancement in six cases. Seven of eight patients required surgery for diagnostic or therapeutic purposes. Complete resolution was determined using both colonoscopy and CT. As more than half of these cases could have been safely managed using an adequate antibiotic treatment, diagnostic studies indicating a high likelihood of colonic actinomycosis should be evaluated to avoid unnecessary surgeries carried out for diagnostic purposes. A combination of colonoscopy and CT appears to be important for both diagnosis and management because of their compensatory findings of mucosal and extramucosal lesions, respectively.

Actinomycosis↗
PubMed1998

Nine year survey of 138 ectopic pregnancies.

During the nine years (1986-1994), 138 women underwent surgery for ectopic pregnancies (One for every 213 deliveries). The commonest presenting symptom was abdominal pain (96%) followed by vaginal bleeding (83%). Four patients were asymptomatic and were diagnosed at a routine antenatal ultrasound scan. The most frequent physical findings were abdominal tenderness (87%) and followed by adnexal tenderness (57%). Histories of infertility in 17%, use of intrauterine contraceptive device (13%), and previous ectopic pregnancy in 11% were elicited. Eleven patients (8%) had a false negative urinary pregnancy test and subsequently required surgery. The ectopic pregnancies were tubal in 97% of the cases. There were 3 ovarian ectopics and one cervical ectopic.

Abdominal Pain↗
PubMedDate not supplied

Candida funisitis: A clinicopathologic study of 32 cases.

We report on 32 cases of Candida funisitis and describe the associated clinicopathologic features. The Candida funisitis was characterized grossly by small, circumscribed, yellow-white nodules on the umbilical cord surface and, microscopically, by subamnionic microabscesses in which fungal organisms were demonstrable. Chorioamnionitis was present in all cases. Twenty-four (75%) of the 32 infants were premature. There were 7 perinatal deaths, all in immature fetuses. Five (16%) of the 32 fetuses had congenital candidiasis. Five (16%) of the mothers had a history of intrauterine foreign body, including intrauterine contraceptive device in three and cervical cerclage in two. The diagnosis of Candida funisitis should prompt a careful examination for fetal infection, even though it is associated with congenital candidiasis in only a minority of the cases.

Adult↗
PubMed2007

Intravesical Cu-T emigration: an atypical and infrequent cause of vesical calculus.

Transuterine transvesical emigration of an intrauterine contraceptive device is a rare and uncommonly described complication of an intrauterine device. We report and describe the clinical outcome and management of one such case of intravesical intrauterine device that had become calcified leading to the erroneous diagnosis of a vesical calculus. The diagnosis was confirmed after cystoscopic visualization, lithoclasty and extraction of the calcified plaque consisting of the Cu-T. A migrated IUD is a rare and infrequent cause for the formation of secondary vesical calculi. The treating surgeon should be aware of the possibility of such episodic cases of vesical calculi occurring in the women presenting with recurrent unexplained urinary sepsis.

Adult↗