Intrauterine contraceptive devices--a reappraisal
| Autor: | Bromham Dr |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Population Pregnancy Pelvic inflammatory disease medicine Humans Vaginal bleeding Levonorgestrel Prospective cohort study education Gynecology education.field_of_study Ectopic pregnancy Obstetrics business.industry Age Factors General Medicine Bacterial Infections Equipment Design Middle Aged medicine.disease Pregnancy Ectopic Family planning Female medicine.symptom business Genital Diseases Female medicine.drug Intrauterine Devices Pelvic Inflammatory Disease |
| Zdroj: | British medical bulletin. 49(1) |
| ISSN: | 0007-1420 |
| Popis: | In 1987 it was estimated that 84.5 million women worldwide used the IUD. The Nova Novagard Multiload-375 and TCu380A IUDs are as effective as the combined oral contraceptive and also permit a longer intrauterine life span. The TCu380A has a failure rate of 1.4/1000 women after 72 months of use. TCu380Ag has been improved by the addition of silver and its pregnancy rates are around 0.7% after 24 months. The levonorgestrel (LNG)-IUD releases 20 mcg of LNG daily and has pregnancy rates of 1.1% after 5 years. Pelvic inflammatory disease (PID) and ectopic pregnancy rates of 0.5 and 0.03% woman-years (WY) in one study were lower than with copper-IUDs (2.0 and 0.25% WY). With Cu-Safe IUDs high continuation rates (89.1%) low rates of pregnancy (0.6% WY) expulsion (0.6% WY) and pain and bleeding removal (5.7% WY) have been achieved over the first year in 1017 acceptors even though > 80% of the acceptors were nulligravid. Initial studies showed 0.3% WY pregnancy and 0.6% WY expulsion rates at 18 months with Cu-Fix or flexigard devices. The American Womens Health Study found a significant relative risk (RR) of PID of 1.6 in IUD-users versus non-users and a significant risk reduction of RR of 0.82 for IUD-users versus non-contraceptors. A 12-month study of 1265 women being fitted with either a standard TCu 200 device or a TCu 200 with tail removed showed no difference in the incidence of PID. A recent prospective study of 100 women with actinomyces-like-organisms-positive cervical smears found no difference in the prevalence between copper and plastic IUD users. The incidence of ectopic pregnancies in IUD users who had a history of PID was at least 4 times that in other users. Further topics are the timing of IUD insertion postplacental insertions prevention of perforation embedding and partial perforation missing strings and timing of removals. Vaginal bleeding mode of action of the IUD and its cultural religious and ethnic implications are also discussed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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