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Safety of copper T as contraceptive after caesarean section.
Copper T was inserted in 45 cases following caesarean section. Motivation was easier, acceptance was higher and follow-up was good in this group of patients. With proper selection and careful follow-up complications could be reduced to the minimum.
Comparative study of copper T and loop insertion.
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Duration of use of copper releasing IUDs and the incidence of copper wire breakage.
The incidence of copper wire breakage for IUDs (Multiloads) using 0.3 and 0.4 mm diameter copper wire was evaluated by examining 969 devices that had been removed for various reasons. The IUDs were examined by light microscopy to determine the integrity of the copper wire. As expected, the incidence of breakage increased with increasing duration of IUD use. The cumulative breakage rate (life table) was significantly lower (p less than 0.05) for the Multiload 375 that used 0.4 mm diameter wire, compared to the Multiload 250 that used 0.3 mm diameter wire. The cumulative rates were 5.4 per 100 IUDs after 3 years for the Multiload 250, and 3.8 per 100 IUDs after 5 years for the Multiload 375. In only 1 (0.1%) of the 969 Multiloads examined, the breakage of the copper wire was sufficiently extensive to adversely affect the user's risk of pregnancy.
The intrauterine device and ovarian pregnancy.
Within a 1-year period, three patients presenting to the University of Chicago, Chicago Lying-In Hospital with a complaint of lower abdominal pain were diagnosed at laparotomy to have ovarian pregnancies according to the criteria of Spiegelberg. All of the patients were at the time using the Copper-7 intrauterine device for contraception. There are now 50 known cases of ovarian pregnancies in patients using the intrauterine device (IUD). The characteristics of these patients do not differ markedly from those previously reported in studies on tubal pregnancies, with and without the IUD, but the presentation of patients tends to be more variable than in tubal pregnancies. The increasing incidence noted here, in a population already known to be particularly prone to pelvic inflammatory disease and therefore ectopic pregnancies in general, lends further credence to a questioning of the desirability of the IUD in such a population.
Primary tubal infertility in relation to the use of an intrauterine device.
Women who use an intrauterine device (IUD) are at increased risk of acute pelvic inflammatory disease, but the relation of the IUD to subsequent infertility is not established. We interviewed 159 nulligravid women with tubal infertility to determine their prior use of an IUD. Their responses were compared with those of a matched group who conceived their first child at the time the infertile women started trying to become pregnant. The risk of primary tubal infertility in women who had ever used an IUD was 2.6 times that in women who had never used one (95 per cent confidence interval, 1.3 to 5.2). The observed difference between cases and controls was not uniform for different types of IUD. The relative risk associated with use of a Dalkon Shield was 6.8 (1.8 to 25.2), and that associated with use of either a Lippes Loop or Saf-T Coil IUD was 3.2 (0.9 to 12.0). The smallest elevation in risk was found among users of copper-containing IUDs (relative risk, 1.9 [0.9 to 4.0] for all women who had ever used a copper-containing IUD). The relative risk for women who used only a copper-containing IUD was 1.3 (0.6 to 3.0). We conclude that use of the Dalkon Shield (and possibly of plastic IUDs other than those that contain copper) can lead to infertility in nulligravid women.
Tubal infertility and the intrauterine device.
To study the association between intrauterine devices (IUDs) and pelvic inflammatory disease, we compared contraceptive histories in 4185 while women--283 nulliparous women with primary tubal infertility, 69 women with secondary tubal infertility, and 3833 women admitted for delivery at seven collaborating hospitals from 1981 to 1983. The relative risk of tubal infertility associated with IUD use was calculated by means of multivariate logistic regression to control for confounding factors, including region, year of menarche, religion, education, smoking, and reported number of sexual partners. The adjusted risk of primary tubal infertility associated with any IUD use before a first live birth was 2.0 (95 per cent confidence limits, 1.5 to 2.6) relative to nonuse. Users of the Dalkon Shield had an adjusted risk of 3.3 (1.7 to 6.1), users of the Lippes Loop or Saf-T-Coil had a risk of 2.9 (1.7 to 5.2), and users of copper IUDs had a risk of 1.6 (1.1 to 2.4). Women who reported having only one sexual partner had no increased risk of primary tubal infertility associated with IUD use. The adjusted risk of secondary tubal infertility associated with use of a copper IUD after a first live birth was not statistically significant (1.5; 95 per cent confidence limits, 0.8 to 3.0), whereas the risk from similar use of noncopper devices was significant (2.8; 1.3 to 5.9). We conclude that tubal infertility is associated with IUD use, but less so with copper IUDs.
Septic abortion and IUCDs.
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Retrograde cervical perforation by the copper-T device.
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[Contraception in the immediate period following voluntary interruption of pregnancy (V.I.P.)].
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Abdominal wall actinomycosis associated with use of an intrauterine device: a case report.
The association between pelvic actinomycosis and the use of intrauterine devices is well established. However, abdominal wall actinomycosis without clinical involvement of the pelvic organs has been reported only once in the literature. The authors present a second case, which occurred in a 24-year-old woman who was using a copper 7 intrauterine device.
[Intrauterine contraception in nulliparous women].
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Auger and pixe microanalysis of intrauterine devices (IUDs).
Auger Emission Spectroscopy (AES) and Particle Induced X-ray Emission (PIXE) analysis were employed in a study on the calcification and oxidation processes of the copper wires used in Intra-Uterine Device (IUDs) contraceptives. A strong copper release (approximately 50 micrograms/day) has been observed in the first year of IUDS application during the high device antifertility effect. The copper release is reduced with the IUD-use time, because of the calcification process on the surface by organic liquids. This effect produces a drastic reduction in the contraceptive efficiency, and a new IUDs replacement is needed after about 2 years of use. Auger, X-ray spectrometry and scanning electron microscopy (SEM) have been used to investigate the lifetime and efficiency of IUDS in order to understand the surface modification of copper wire during its permanence in the intrauterine environment.
Heterotopic pregnancy. The first case with an IUD in situ.
The first reported case of simultaneous tubal and intrauterine pregnancy in a women with an IUD in situ is presented. The incidence of combined pregnancies is estimated as 1 to 2 pr. 10,000 gestations. The risk of IUD using women for becoming combined tubal and intrauterine pregnant is calculated as 1:6,000,000 women years of use.
Bladder stone in a human female: the case of an abnormally located intrauterine contraceptive device.
A single 4.7 x 3.3 x 1.5 cm solid nodule was removed from the bladder of a 24 years old white female who had lost an intrauterine contraceptive device (IUD) installed approximately four years ago. The nodule showed no external evidence of an IUD or its string. An examination of the nodular surface by scanning electron microscopy (SEM) showed mostly amorphous material with some adherent filamentous structures. Its energy dispersive x-ray microanalysis revealed the presence of calcium and phosphorus suggesting that the nodule was actually a urolith. Fracturing the nodule exposed an embedded entity consistent with being a copper IUD. Apparently, the lost IUD had migrated from the uterus into the bladder where it became mineralized. Thus the solid nodule was actually a foreign body stone.
[The family planning central unit and public health medicine].
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Efficiency and acceptability of intrauterine contraceptive devices.
The efficacy and side effects of 6 different IUDs used by 790 women during 22826 menstrual cycles is reported. The conclusion is that modern IUDs have a negligible effect on the health of users if properly followed by regular checkups.
[The problem of contamination of copper bearing intrauterine devices (author's transl)].
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