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PubMed1979

Presence of elevated circulating levels of LH during the pre-menstrual period in some copper IUD users and the possibility of their confusion with hCG.

A heterologous radioimmunoassay (RIA) capable of discriminating between LH and hCG was used to measure LH levels in sera obtained during the pre- and post-menstrual periods from 80 women bearing copper intrauterine contraceptive devices (IUD). hCG levels in these samples were also estimated by use of a homologous beta-hCG radioimmunoassay and a radioligand-receptor assay. Only two IUD users during the pre-menstrual period had detectable, but low hCG levels. However, LH levels, as estimated by specific RIA, in the serum of these two women were elevated to a level that would cause detection at low levels in the hCG assays. The data thus provide direct evidence to indicate that the positive hCG levels observed by others during the pre-menstrual period in some copper IUD users could be due to the interference in hCG assays by elevated LH.

Adult↗
PubMed1981

Intracervical release of levonorgestrel for contraception.

Twenty-one women used a levonorgestrel-releasing intracervical contraceptive device, which was designed to release 20 microgram/ay. The devices were inserted after cessation of menstrual bleeding. Patterns of bleeding and clinical performance wer evaluated and plasma concentrations of levonorgestrel, estradiol and progesterone in selected subjects were measured by radioimmunoassay. The results of the initial 90-day treatment are presented. Levonorgestrel was detected in peripheral plasma by 30 minutes after insertion of the device. Considerable variation of plasma levonorgestrel concentrations was observed between subjects, but within each subject, the plasma level of levonorgestrel was very stable with time. Of 24 cycles monitored by blood sampling, 19 were ovulatory. One subject did not ovulate at all. During the first 30-day period of treatment, frequent intermenstrual bleeding or spotting periods occurred. Two spontaneous expulsions occurred 9 and 22 days after insertion. Both of these subjects were nulligravidas. Side-effects were few and no pregnancies occurred during the study period.

Adult↗
PubMed1982

Levonorgestrel in milk and plasma of breast-feeding women with a levonorgestrel-releasing IUD.

A levonorgestrel-releasing intrauterine contraceptive device was used by 10 breast-feeding women beginning 6 weeks after delivery. Two models of IUD were used. One released 10 microgram (5 patients), the other 30 microgram (5 patients) of levonorgestrel per day. Plasma and milk samples were collected 8 times over a 3-month period and the concentrations of levonorgestrel determined by radioimmunoassay. An improved and sensitive method for the determination of levonorgestrel in milk was developed. A column chromatographic purification of a milk extract before radioimmunoassay made possible the use of large milk samples in order to improve the sensitivity. The plasma concentrations during the follow-up period were 207 +/- 64 pg/ml (mean + SD) in the 10 microgram and 235 +/- 87 pg/ml in the 30 microgram/day releasing IUD groups. The milk levonorgestrel concentrations were 56 +/- 35 and 57 +/- 34 pg/ml, respectively. The plasma to milk ratio of levonorgestrel was initially 100:15 and at the end of the 3-month follow-up period 100:25. There were no significant differences in the milk and plasma concentrations between the study groups. The total amount of levonorgestrel excreted per day in 600 ml breast milk is approximately 0.1 per cent of a daily dose of 30 microgram.

Breast Feeding↗
PubMed1985

Investigation into the effects of the photodecomposition of norethisterone by UV-B light on Salmonella typhimurium TA98 and the rat.

In view of the light-induced side-effects of the oral contraceptive pill and the development of injectable and subdermal contraceptive devices, the effects of norethisterone irradiated with UV-B light (280-320 nm) on the microorganism Salmonella typhimurium TA98 and male Wistar rats have been investigated. The observed cytotoxic effect of the photo-products on Salmonella typhimurium TA98 may in part be caused by the irreversible binding of steroid to protein from this bacterium, of which binding is in line with previous experiments. However, after intraperitoneal or percutaneous administration of 4-14C-norethisterone to rats, followed by irradiation with UV-B light, no significantly higher level of radioactivity was observed in blood, organ material of the skin, kidney or liver, on extraction or dialysis of the samples.

Absorption↗
PubMed1989

Barrier methods of contraception and the risk of cervical neoplasia.

The relationship between the use of barrier contraception methods and the risk of cervical neoplasia was analyzed using data from a case-control study conducted in the greater Milan area, northern Italy. A total of 367 cases of invasive cancer under 60 years of age were compared with 323 subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer, and 316 cases of cervical intraepithelial neoplasia were compared with 258 outpatient controls. Ever-use of barrier methods (condom and diaphragm) was reported by 6% of the cases of invasive cancer and 12% of hospital controls. Corresponding values for intraepithelial neoplasia were 16% for cases and 22% for outpatient controls. Considering the total use of barrier methods, compared to never use, the relative risk of invasive cervical cancer was 0.4 (95% confidence interval 0.2-0.9) and decreased with duration of use (chi 2(1), trend = 5.18, p = 0.02). Likewise, use of barrier methods lowered the risk of intraepithelial neoplasia; the estimated relative risks were 0.9 in users for less than two years and 0.6 for two or more (chi 2(1), trend = 4.61, p = 0.03). Although the protection for invasive cancer appeared to be greater at older ages and in multiparous women, the relative risks were not significantly heterogeneous in various strata of parity, number of sexual partners, oral contraceptive use and history of Pap smears.

Adolescent↗
PubMed1993

Cells adherent to IUDs produce tumor necrosis factor alpha.

The nature of adherent cells obtained from the surface of intrauterine contraceptive devices (IUD) was investigated by immunofluorescence using antibodies directed against tumor necrosis factor alpha (TNF), leukocyte differentiation antigens, immunoglobulin isotypes and J chain. Macrophages/monocytes, lymphocytes and neutrophils were found in all fifty samples. Macrophages were characterized by CD14, CD15 and CD71 positivity, DAKO macrophage antibody and HLA-DR, CD11c and CD45 expression. B cells contained secretory IgA with J chain or IgG and some cells expressed surface IgM. Neither IgD nor IgE were found. T-antigens CD3, CD4 and CD5 were not detected, the CD8 was faintly expressed. The CD56 molecule identifying NK cells was found on small lymphocytes. Cytoplasmic C3 protein was detected in neutrophils. Tumor necrosis factor alpha (TNF) was visualized in 14.3 +/- 8.8% of nucleated IUD cells. This cytokine was localized in the cytoplasm of the macrophages and the lymphocytes.

Adult↗
PubMed1995

Adolescent contraceptive use and its determinants in Bangladesh: evidence from Bangladesh Fertility Survey 1989.

This study is concerned with contraceptive use among the currently married adolescents in Bangladesh utilizing the 1989 Bangladesh Fertility Survey (BFS) data. The study analyzes the factors affecting the current use of contraception among the adolescents through bivariate and multivariate logistic regression analysis. The results indicate that although adolescents have almost universal knowledge about contraceptive methods, only 15 percent are currently using any method of contraception. The corresponding figures for the adults and for the nation as a whole are 34.4 percent and 31.4 percent, respectively. Among the individual methods currently used by the adolescents, the pill appears as the most popular method, followed by safe period. A substantial proportion of the adolescents were found to rely on the traditional methods of contraception. Among the socio-economic variables (as revealed by the logistic regression analysis), respondents' education, participation in the family planning decision, visit by family planning workers, region of residence, husband's occupation and possession of electricity in the household appear as the most significant factors determining the current use of contraception among the adolescents.

Adolescent↗
PubMed1993

Ovarian pregnancy.

Ovarian ectopic pregnancy occurs very rarely; the reported incidence is only 1:7000-40,000 deliveries, despite various reports in recent years. We present four cases of primary ovarian pregnancy which were managed in the King Khalid University Hospital (KKUH) over a 5-year period representing a prevalence rate of 19.9 per 100,000 deliveries. All four cases complied with the four criteria of Spiegelberg. None of the patients were known to have used an intrauterine contraceptive device which had been suggested as the cause of ovarian pregnancies in several studies. Fertility after surgery in these cases was unaffected.

Adult↗
PubMed1975

Immature delivery after intrauterine Candida albicans infection.

The case is presented of a patient who delivered an immature infant after an intrauterine candidial infection in the presence of an intrauterine contraceptive device (IUD). 8 other cases of intrauterine Candida infection leading to immature deliveries were gathered from the literature. On the basis of the pathologic findings, the medium of infection is thought to be the amniotic fluid.

Adult↗
PubMed1976

Tubal and uterine motility in vivo in the rhesus monkey.

Previous data indicate that there are definite qualitative and quantitative patterns of tubal activity during the various phases of the menstrual cycle. In the present investigation, the simultaneous activity of the uterus and Fallopian tube was recorded in vivo in mature rhesus monkeys throughout the menstrual cycle. The observations indicate that there are characteristic patterns of both tubal and uterine activity, depending on the various phases of the menstrual cycle. The simultaneous recordings of tubal and uterine activity show that the tubal and uterine contractions are not synchronous or even have a similar pattern. The presence of a transmetrial catheter for recording of uterine activity seems to modify the patterns of tubal activity, particularly during the ovulatory phase. It seems possible that the transmetrial catheter has a similar effect as an intrauterine contraceptive device in this species.

Animals↗
PubMed1979

Female genital actinomycosis.

Four cases of female genital actinomycosis are added to the reported total of about 300. The relationship of the disease to the normal microbial flora, intrauterine contraceptive device usage and pelvic sepsis is explored. It is suggested that the disease may be more frequent than hitherto realized.

Abscess↗
PubMedDate not supplied

Nurse midwives' attitudes toward abortion performance and related procedures.

In 1990 a symposium was held by the American College of Obstetricians and Gynecologists and the National Abortion Federation to address the national shortage of physician abortion providers. One symposium recommendation was that nurse-midwives be trained to perform first-trimester legal abortions under physician supervision. A national mail survey was conducted to determine the attitudes of nurse-midwives toward performing abortion and related procedures. One-half of the nurse-midwives who were members of the American College of Nurse-Midwives as of October 1991 were polled, and 1,208 questionnaires (71.1%) were returned, resulting in a sample representative of the general membership and students. Seventy-nine percent of respondents would not support federal and state efforts to limit access to abortion, 52% would or possibly would vote in a secret ballot to permit the performance of abortion by certified nurse-midwives; 24% would, or possibly would, incorporate abortion procedures into their practice; and 19% would, or possibly would, perform abortions in an abortion clinic. The lowest level of support to permit the certified nurse-midwife practice of abortion came from the midwest (31%) and southeast (41%) and the greatest from the west coast (65%). Supporters for the nurse-midwife performance of abortion were more likely to have practiced well-woman gynecology and provided abortion-related services such as abortion referrals, pre- and postabortion workups and the treatment of abortion-related complications. They were more likely to have inserted intrauterine contraceptive devices and laminaria, and to have performed circumcision. Opinions about the performance of abortion were not related to age, education, or student status. The majority of nurse-midwives (91%) would be willing to refer a woman to another provider for an abortion, prescribe RU 486 (57%), and perform dilation and curettage for spontaneous abortion (56%). The American College of Nurse-Midwives membership reported many different reasons for support of and opposition to professional involvement with abortion. Further research suggestions for institutional policy and individual practice are offered.

Abortion, Legal↗
PubMed2004

[Pelvic actinomycosis revealed by pelvic peritonitis].

Pelvic actinomycosis is an infection due to actinomyces organism associated with an intra-uterine contraceptive device. This infection is often revealed by an uni- or bilateral adrenal lesion. Lesions are sometimes more extensive and affect next pelvic organs: rectum, ureter, bladder. Diagnosis is often histologic with percutaneous biopsy or surgical biopsy (laparotomy or coelio surgery). Treatment is mainly medical with prolonged use of penicillin (6 months in severely cases). Surgery must be thrifty and conservative.

Actinomycosis↗