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Results for “Intrauterine Device Expulsion”

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At least 19 recordsLinked to original sources

Hormone-releasing silastic intrauterine devices: effect or provera-releasing intrauterine devices on two species of primates.

Silastic intrauterine contraceptive devices (IUDs) 13 mm long and 1.07 mm in diameter could be inserted easily into patas monkey uteri which, like human uteri, expelled them. Addition of 10% Provera to these devices did not reduce the expulsion rate significantly in our study. Control devices had no effect on cycle length in rhesus monkeys. After insertion, the active IUDs frequently caused a delay in onset of menstruation; however, cycles did occur with the device in situ, and normal-length cycles were resumed following removal of the device. A short period of rapid release (almost 35% of the total amount) of Provera from the device was followed by a longer period of sustained release of low levels of the hormone. Even 9 mug/day were sufficient to maintain a decidual reaction in the endometrium of the rhesus monkey. The drug could not be detected in the blood stream at 3,6, or 12 hours in patas monkeys or at 1 or 2 months in rhesus monkeys and so may never have reached the systemic circulation. Devices currently under study in baboons catain Provera or one of three other steroids to determine whether these compounds improve retention rates as well as meet the other two criteria set for the ideal IUD incorporation, for unless we meet this first criterion we can never achieve, let alone test, the others.

Animals

A three-year trial of the Gravigard (Cu-7) intrauterine device.

The Gravigard (Cu-7) intrauterine device was evaluated in 201 patients (106 nulligravid, 20 nulliparous and 75 multiparous) for a period totalling 4,794 menstrual cycles. Only 4-9% of all insertions of the device proved difficult. Nine involuntary pregnancies occurred at a life-table rate of 3-0 +/- 1-3 per 100 women during the first year. Both pregnancies and expulsion of the device occurred more frequently in nulliparous than in multiparous women. Most expulsions of the device occurred during the first six months of use. A continuation rate of 72-6 per 100 women was achieved during the first year, of 58-2 per 100 women during the intial two years, and of 36-0 per 100 women during the three years of the trial. One of the most noteworthy features of this new IUCD is the extreme ease of its insertion in both nulliparous and multiparous patients.

Adolescent

Postabortion insertions of the pleated membrane.

The pleated or intrauterine membrane (IUM) was designed to fit a range of uterine sizes and shapes and to adjust to transient changes resulting from uterine motility. The retention and contraceptive abilities of postabortion IUM insertions are analyzed in this study of 154 IUM insertions made within 3 days of treatment for an incomplete or inevitable abortion. Results indicate low 1-year net cumulative event rates for pregnancy (1.7 per 100 users), expulsion (7.2 per 100 users), and removal for bleeding and/or pain (3.9 per 100 users). These rates were similar to those reported in a study of interval insertions of the IUM; moreover, these results also compared favorably with corresponding rates of postabortion insertions reported in studies using other devices. Thus, the postabortion period is indicated as being an effective time for IUM insertion.

Abortion, Induced

Comparison of three intrauterine contraceptive devices: the Antigon-F, the Ypsilon-Y, and the Copper-T 200.

A comparative study of three intrauterine contraceptive devices, the Antigon-F, the Copper-T, and the Ypsilon-Y, was carried out at The New York Hospital Cornell Medical Center during an 18-month period from March 1, 1972, through August 31, 1973. At the cutoff date of February 28, 1974, all patients had been followed for at least 6 months. During the period of study, 884 Antigon-F devices, representing 14,436 woman-months of use, were inserted. The over-all pregnancy rate was 0.88, with an explusion rate of 5.1 and a medical removal rate of 9.1/100 woman-years. This device was best tolerated by multiparous women. There was a total of 910 insertions of the Ypilson-Y, representing 14,348 woman-months of use. The over-all pregnancy rate was 1.8, with an explusion rate of 1.9 and a medical removal rate of 3.7/100 woman-years. The pregnancy rate in nulliparous women was 0.78, with a continuation rate of 88.9. The pregnancy rate in multiparous woman was higher, i.e., 2.4. Nine hundred thirty-nine Copper-T 200 devices, representing 15,558 woman-months, were inserted. The over-all pregnancy rate was 0.85, with an expulsion rate of 1.8, a medical removal rate of 4.5, and a continuation rate of 88.4/100 woman-years. The pregnancy rate was 0.82 for nulliparous women and slightly higher, i.e., 1.04, for multiparous women. Thus, all three devices had considerable merit. The Antigon-F and the Copper-T seemed the best in multiparous women; the Ypsilon-Y in the size used was best in nulliparous women. The only perforations occurred with the Copper-T.

Copper

Combined and national experience of postmenstrual IUD insertions of Nova-T and Copper-T in a randomized study.

A randomized comparative study between Nova-T and Copper-T-200 was performed simultaneously in Denmark, Finland and Sweden. The results of 741 postmenstrual insertions with Nova-T and 780 with Copper-T are reported. The pregnancy rate of Nova-T was lower in every age and parity group. The pregnancy rate of Copper-T-200 varied in participating countries, whereas the pregnancy rate of Nova-T was equally low in every country. The termination rate because of expulsion with Nova-T was less affected by age and parity than that of Copper-T. Significant differences in the continuation rates with the same device were found between countries. Removals because of infection showed that women below 25 years of age had a high risk for infection regardless of parity.

Adolescent

Randomized comparative study of the copper T 300, Dalkon shield, and Shell Loop in parous women.

A randomized comparative study of the Copper T 300, the standard Dalkon Shield and the Silicone Shell Loop D was conducted on 776 parous women. Net cumulative first event rates at 1 year and at 18 months, calculated by life-table analysis, were as follows: Copper T 300--pregnancy 1.2/1.9, expulsion 6.4/7.0, removal for pain or bleeding 7.4/10.8; Dalkon Shield--pregnancy 2.7/4.5, expulsion 5.8/5.8, removal for pain or bleeding 7.7/14.7; Shell Loop--pregnancy 3.8/4.9, expulsion 0.5/0.5, removal for pain or bleeding 9.1/13.1. None of the differences in event rates, except the lower expulsion rate of the Shell Loop, were significant. The continuation rates for the three devices at both 12 and 18 months were similar, indicating that there was little difference in their performance. As the results of this study showed a similarity of the incidence of events among very differently disigned IUD's, previously reported differences in performance of these and possibly other types of IUD's may very likely be more related to differences among clinics than to differences among the devices themselves.

Adolescent

The multiload IUD--a U.S. researcher's evaluation of a European device.

This evaluative review focused on the performance and safety of the Dutch-made Multiload copper IUD, primarily the Multiload-375 (MLCu-375) model which has a longer life expectancy (5 or more years) than the Multiload-250 (MLCu-250) model, usually cited for a life expectancy for three years. This copper-medicated IUD differs from the copper-T IUDs in shape and insertion technique. The review shows that (a) the MLCu-375 IUD seems to be slightly less effective in preventing pregnancies than TCu-380A IUD. Its efficacy is comparable to that of the Nova-T by two to three years of use; (b) the MLCu-250 IUD is similarly effective to TCu-200 but may be slightly less effective than TCu-220C; (c) no consistent differences were detectable in expulsion rates or in removal rates for bleeding/pain between the Multiload IUDs and comparative Copper-T IUDs; (d) the Multiload IUDs may perform better in nulliparous women than the T-shaped devices; (e) no or a very low incidence of uterine perforation is associated with insertions of the Multiload IUD; (f) ectopic pregnancy risks are similarly low in Multiload IUD users as in Copper-T-380A users; and (g) pelvic inflammatory disease (PID) risks are similarly low in Multiload IUD users as in users of T-shaped copper IUDs.

Evaluation Studies as Topic

Contraceptive efficacy of two different metals using a modified seven vector.

Early studies with copper suggested that few improvements in overall IUD performance could be obtained with the use of more than 200 mm2 of copper. Thus, the use of other metals paired with copper has been investigated. This report of two studies of the small Copper-7, one with zinc and the other with copper alone, suggests that the addition of zinc in the superior position of the small Cu-7 decreases the incidence of pregnancy and that the small Cu-7 may be associated with higher retention rates than the standard Cu-7.

Adult

Evaluation of trained midwives in a copper-T IUD insertion Program in Isfahan, Iran.

From four centers in Isfahan, data from 252 insertions of the Cu-T-200 made by midwives and 646 insertions of the same device made by doctors are compared. Although the net cumulative one-year continuation rate for women who had a copper-T inserted by a midwife is significantly lower than for women who had a copper-T inserted by a doctor there are no significant differences between the one-year event rates for the two groups of patients. These data suggest that an expanded role for midwives in IUD insertion programs would be an efficient use of health personnel.

Copper

A multicenter clinical trial in Nigeria with Multiload-Cu250 (MLCu250) and Multiload-Cu375 (MLCu375) intrauterine devices.

A multicenter study was conducted in Nigeria, comparing the Multiload-Cu250 (MLCu250) with the Multiload-Cu375 (MLCu375). The two intrauterine devices were studied on aspects of effectiveness and acceptability. Parameters were observed and analyzed, using the life-table method of Tietze and Lewit. Continuation rates were excellent. Overall results were in line with studies done elsewhere in the world with Multiload devices, showing a slight superiority of the MLCu375 over the MLCu250.

Female