Contraceptive Device Research Articles

Laparoscopic retrieval of a misplaced intrauterine contraceptive device translocated into the transverse colon and bladder: A case report

Background: Intrauterine contraceptive device (IUCD) translocation is a rare but severe complication that can present challenges in patient identification, diagnosis, and management.
 Case presentation: A 37-year-old para 3+0 presented to the gynecology clinic with a 12-year history of right inguinal pain. Pelvic ultrasound and lumbosacral x-ray showed a radiopaque foreign body in the pelvic cavity. Initial laparoscopic retrieval attempts had been unsuccessful, and she was scheduled for a repeat attempt. Intraoperatively, a hysteroscopy showed a normal endometrial cavity and normal ostia bilaterally with no IUCD visualization. On laparoscopy, the IUCD was located within a thick adhesion band connecting the transverse colon to the urinary bladder. Adhesiolysis was performed, and the IUCD was retrieved.
 Conclusion: IUCD translocation can be prevented by proper insertion techniques and placement confirmation. When translocation is suspected, diagnostic imaging modalities are essential, and surgical removal by a multidisciplinary may be required

Clinical practice guidelines for endometriosis in Japan (The 3rd edition).

Clinical practice guidelines for endometriosis in Japan (The 3rd edition).

Study of Risk Factors in Patients of Pelvic Inflammatory Diseases

Number of risk factors has been associated with pelvic inflammatory disease, such as age, previous sexually transmitted infection, previous PID, multiple sexual partners, or an intrauterine contraceptive device. Women who use an intrauterine device for contraception are at least 2-4 times more likely to develop PID than non-users. Women who have had PID are twice as likely to develop the infection as those who have never had it. A history of a prior uncomplicated gonococcal infection is more common among women with PID than among women without disease. The present cross- sectional study was conducted in J.N. Medical College and Hospital (J.N.M.C.H.), Aligarh Muslim University, Aligarh. Permission for doing the study was taken by the Board of Studies in the Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. The study was carried out for a period of one year, from 1st August 2001 to 31st July 2002. The present study was carried out among ever married females in the reproductive age group of 15 to 49 years. Women, who gave positive history of PID, were asked to give their consent for the study. Their refusal was taken as exclusion criteria. Females with PID who were menstruating or who had taken antibiotic within the previous month were also excluded from the study. A total of 350 ever married females were selected from the Gynaecology OPD of J.N. Medical College Hospital (n=170), Urban Health Training Centre (n=100) and Rural Health Training Centre (n=80).A detailed clinical history and clinical examination were recorded on a pre-formed and pre tested proforma. All the females under study were subjected to per vaginal examination. The percentage of those female was more who used any cloth during menstruation. Out of 350 patients, 7.4% ga ve history of T.B, 24% gave history of previous episodes of PID, 12.0% gave history of MTPs/D&Cs. 5.1% had adopted IUCDs as a method of family planning.1.71% cases gave history of removal of IUCDs because of some complications. 75.0% of 80 cases (who adopted family planning) used IUCDs, OCPs and ligation. IUCDs, OCPs, ligation and irregular use of condoms probably increase chances of PID.

Impact of combined endometrial resection or ablation and levonorgestrel intrauterine device on postoperative bleeding pattern.

The aim of this study was to describe the rate of amenorrhea in women treated with transcervical endometrial resection (TCER) or radiofrequency endometrial ablation combined with levonorgestrel intrauterine contraceptive device (LNG-IUD) six months post-operatively. The study was performed as a prospective cohort study. All patients were included at four gynecological centers in Region of Southern Denmark. In total, 162 women referred due to menorrhagia, metrorrhagia or menometrorrhagia and offered TCER or radiofrequency endometrial ablation in combination with or without LNG-IUD included during November 2018 to June 2021 at the women's own discretion and without any cost (covered by the hospital). Data were analyzed using a multivariate regression model. In total, 58 women were offered TCER and 31 (53.4%) combined treatment with TCER + LNG-IUD. Among 104 women who received radiofrequency endometrial ablation, 46 (44.2%) underwent combined treatment with LNG-IUD. The incidence of amenorrhea was 26% among women who underwent treatment with TCRE and 52% when treated with TCER + LNG-IUD (adjusted OR 5.16; 95% CI 1.35-19.6;P < 0.016). Radiofrequency endometrial ablation was followed by a 41% incidence of amenorrhea, and when radiofrequency endometrial ablation was combined with LNG-IUD, the incidence of amenorrhea was 63% (adjusted OR 2.15; 95% CI 0.86-5.37;P < 0.1). We observed no statistically significant differences when comparing the groups across. Our study suggests that the combination of TCER or radiofrequency endometrial ablation with LNG-IUD was superior to TCER. However, the combined treatment of radiofrequency endometrial ablation with LNG-IUD did not reach statistical significance. Further studies are needed to evaluate the effects of different ablation techniques on the amenorrhea rate.

Overview of Student Skills in Phantom-Based Contraceptive Device Installation

Introduction: The laboratory is a very important element as a means in various scientific activities. The results of the study explain that practicum activities are one of the efforts that can be made to improve science process skills and students' critical thinking skills. Aim: This study aims to describe the skills of students in the installation of a phantom-based intrauterine device (IUD) in the practical course Women's Health and Family Planning. Method: This research is a descriptive observational study. The population in this study were all level 2 students of the D3 Midwifery study program. The sampling technique used a total sampling of 38 people. The instrument used in this study was a checklist for the installation of an intrauterine device. Result: The results showed that students who were able to install phantom-based intrauterine devices were more than 26 people (68.4%), while students who were proficient at installing phantom-based intrauterine devices were fewer, namely 12 people (31.6%). and students who need improvement in installing contraceptives in the womb are 0 people (0%). Conclusion: Overall, the description of students' skills in installing phantom-based intrauterine devices is in the capable category with a percentage of 68.4%. It is hoped that in the next practicum students will be proficient in installing phantom-based intrauterine devices.

Provision of intrauterine contraceptive device sizes better suited to younger women based on outcomes at 1 year

Provision of intrauterine contraceptive device sizes better suited to younger women based on outcomes at 1 year

Family planning knowledge, attitude, and practice among postnatal women in a Medical College Hospital

Background: Family planning methods prevent pregnancy-related health risks for women. Aims and Objectives: This study was undertaken to assess knowledge, attitude, and practice of various family planning methods among postnatal women in a Medical College Hospital. Materials and Methods: A standard predesigned questionnaire was asked to randomly selected 300 postnatal women who delivered at F.M. Medical College and Hospital, Balasore, Odisha, India over a period of 1 year. Data on sociodemographic variables, knowledge regarding various family planning methods, source of information, utilization, and reason for its none use were analyzed. Results: Majority were between the age group of 20–30 years (81%). About 91% were aware of its use. About 82% were aware of its need. About 75% of the women gave history of prior use of birth spacing methods. Withdrawal, oral contraceptive pills (OCP) and barrier were mostly used methods in the past (i.e., 31%, 19%, and 9%, respectively). Child spacing was most common reason for use of family planning methods. Majority were aware of OCPs (79%) followed by sterilization (72%), barrier methods (71%), intrauterine contraceptive device (53%), withdrawal (31%), and injectable (23%). Social circle (54%) and health-care provider (35%) were major source of knowledge. Man reason for non-utilization of family planning methods was desire of child (42%), fear of side effects (17%), and husband and in-law opposition (16%). Conclusion: In spite of high contraceptive knowledge and awareness, the actual use of modern family planning method is not satisfactory in our study which suggests proper counseling and education are required to increase its usage.

Assessment of Women Satisfaction with Pregnancy Outcome and Using of Immediate Contraceptive Postnatal at Baghdad Maternity Hospitals

Back ground: Contraceptive following delivery or an induced abortion reduces the risk of an early unintended pregnancy and it's associated to adverse health consequences The Study aims to assess the women satisfaction in the use of contraceptive devices in the period immediately following delivery or abortion and it's relation to pregnancy outcome. Patients and Methodology: A randomized cross sectional descriptive study carried out In 2 maternity hospitals (AL-Elwiya maternity teaching hospital, AL-Karkh maternity hospital) from both sides of Baghdad. The study sample includes 434 cases of women who were in the labor and abortion wards in the period immediately following delivery or abortion before being discharged home. Data were collected during the period from the 1st of November 2015 to the end of April 2016. Results: revealed that more than half (54.4%) of studied women were married in young age group (18-24 years) and 48.6% of them were at young age (18-24 years) at their first delivery, 36.4% were graduated from university, (90.3%) were living in urban areas . The pregnancy ended with delivery in 65.2% of the studied women and ended with miscarriage in 34.8% of them. A significant association was observed between young age of women and high satisfaction with immediate contraception (p=0.02). The most common cause of non-satisfaction with contraception among studied women was not knowing about the possibility of contraception (97.67%), followed by their wish to increase their family size (39.5%), fear from complications (23.2%), economic causes (18.6%), un cooperation of the family (13.9%), bad effect on breast feeding (9.3%) and unavailability (6.9%). one third (31.1%) of the participants were satisfied with immediate contraception while it is about half (49.1%) of the delivered mothers were satisfied on immediate contraceptive with significant difference found between pregnancy outcome and the women's satisfaction. Conclusion: 49.1% of the mothers were satisfied on immediate contraception after delivery while only 31.1% of the miscarried women were satisfied with immediate contraception. Women from low income families had higher satisfaction with contraception and significant association was found between types of pregnancy outcome and women satisfaction with immediate use of contraceptive devices. Keywords: Assessment, Women Satisfaction, Pregnancy Outcome, Immediate Contraceptive, Postnatal

Comparison of Complications of Postpartum Iucd (Ppiucd) Insertion with Interval Iucd Insertion

Aim: Present study was aimed to compare complications of postpartum IUCD insertion with interval IUCD insertion. Study design: Retrospective study Place and duration: Conducted at Gynae &amp; Obs, AIMC/Jinnah Hospital Lahore during from August 2021 to March 2022. Methods: 110 women who used IUCDs were enrolled in this study. They all were equally divided into two groups (PPIUCD group and Interval IUCD group). Women ages were ranging from 20 to 35years. Patients detailed medical history including age, residence, socioeconomic status were examined after taking written consent. Outcomes were examined at follow-up and compared between both groups. Patients with Chorioamnionitis, Puerperal sepsis, PROM &gt; 18 hrs, Potentially infected dai handling cases, Unresolved PPH were excluded from the study. Data was analyzed by SPSS 20.0. P-value &lt;0.05 was considered as significant. Results: Out of 110 patients of accepted IUCD, most of the patients were aged between 20 to 30 years who had used intrauterine contraceptive device and comprised 77.3%. Women with PPIUCDs had low complication rate as it was reported in 13 cases (23.47%) while (27.19%) was reported in 15 cases of Interval IUCDs group. Pregnancy and perforation was 0%. 48 (87.3%) women were satisfied with their PPIUCDs whereas 45 (81.8%) were satisfied with their Interval IUCDs. Continuation rate with PPIUCD was high 49 (89.1%). Bleeding problem was significantly higher in women with Interval IUCD (9.09%). Women with PPIUCD had more expulsion rate (7.27%). Rate of removal of IUCD in both the groups had minimum difference (9.09% and 10.9%). Conclusion: It is concluded that the insertion of immediate postpartum intrauterine contraceptive devices was effective and safe method with low complications rate. Keywords: PPIUCD, Interval IUCD, complications

The effect of knowledge and attitude of family planning acceptances on iud contraception selection during the COVID-19 pandemic

Introduction: Although several studies on the influence of knowledge and education of family planning (KB) acceptors on the selection of intrauterine contraceptive devices (IUDs) have been carried out previously, research on knowledge and attitudes of family planning acceptors towards the selection of IUDs during the COVID-19 pandemic is still limited. The purpose of this study was to assess the effect of knowledge and attitudes of family planning acceptors on the selection of an intrauterine device (IUD) during the Covid-19 pandemic. Methods: The data used in this study were obtained from filling out questionnaires involving 162 respondents. This study was analyzed descriptively analytically with the parameters of knowledge and attitudes towards the selection of intrauterine devices (IUD) using a bivariate table. Results: This study showed that 38.4% had sufficient knowledge, only 1.2% chose to use the IUD with a p-value of 0.348 &gt; 0.05 and of the 66% who had a positive attitude only 2.5% chose to use the IUD with a p-value 0.146 &gt; 0.05. Conclusion: Although family planning acceptors have sufficient knowledge and a positive attitude, it does not affect the selection of the IUD as an effective long-term contraceptive, so the use of other contraceptives is still recommended as an effort to control fertility according to the needs of the acceptor during the Covid pandemic.

Intracesarean Postpartum Insertion of Intrauterine Contraceptive Device as an Alternative to Delayed Insertion: Safety and Complications

Intracesarean Postpartum Insertion of Intrauterine Contraceptive Device as an Alternative to Delayed Insertion: Safety and Complications

Characteristics of Patients Requiring Surgical Removal of Subdermal Contraceptive Implants: A Case-Control Study.

PurposeEtonogestrel subdermal implants are a commonly used contraceptive device placed in the medial upper arm. Plastic and orthopedic surgeons may be consulted for difficult implant removals. We performed a case–control study comparing patients undergoing surgical and uncomplicated in-office removal at our institution.Patients and MethodsWe identified patients who underwent operative removal of implantable contraceptive devices by plastic or orthopedic surgeons at our institution from January 2014 to October 2019. Patients who underwent uncomplicated office removal during the same time were compared. Demographic and surgical variables were collected, and descriptive statistics were calculated. Univariate and multivariate logistic regression was performed with surgical versus outpatient removal as the outcome of interest.ResultsA total of 669 patients undergoing etonogestrel subdermal implant removals were identified during the five-year study period, of which thirteen patients required surgical removal (1.9%) and 326 were selected as uncomplicated removal comparisons. There were no significant differences in median (IQR) body mass index (BMI) (31.1 [28.2, 35.2] versus 29.3 [24.0, 35.1], p = 0.19), median (IQR) weight gain since device placement (5 [−0.6, 14.7] kilograms versus 1.6 [−1.2, 5.8] kilograms, p = 0.15), or length of time since device insertion (2.3 [0.8, 2.8] years versus 1.0 [0.4, 2.2] years, p = 0.17). Of those who needed surgical removal, the most common indication for implant removal was device expiration (n = 5, 38.5%). Devices placed by OBGYN attendings were less likely to require surgical removal (p = 0.02). Family medicine attendings were more likely to refer patients for surgical removal (p = 0.02). No significant findings were detected on univariate or multivariate regression. Among surgical removals, radiography was the most frequently used imaging modality. Implants were most frequently subdermal (n = 11, 84.6%) though intramuscular placement was also identified (n = 2, 15.4%). Only one patient had residual paresthesia along the length of the incision. No other complications were identified.ConclusionWe did not identify risk factors associated with the difficult removal of etonogestrel subdermal implants. Practitioners should consult upper extremity surgeons if they encounter difficult removals.

Factors associated with discontinuation among long-acting reversible contraceptive users: a multisite prospective cohort study in urban public health facilities in Ethiopia

ObjectiveThe study aims to determine discontinuation among long-acting reversible contraceptive users at 3, 6, 9 and 12 months after initiation and its associated factors among new long-acting reversible contraceptive (LARC)...

Comparing usefulness of immediate postpartum intrauterine contraceptive device among the women undergoing caesarean or vaginal insertion

Comparing usefulness of immediate postpartum intrauterine contraceptive device among the women undergoing caesarean or vaginal insertion

Efficacy and Acceptability of Intrauterine Contraceptive Device Placement during Cesarean Delivery in Comparison with Interval lUCD Isertion at Minia Maternity and Children University: Prospective Randomized Comparative Clinical Study

Efficacy and Acceptability of Intrauterine Contraceptive Device Placement during Cesarean Delivery in Comparison with Interval lUCD Isertion at Minia Maternity and Children University: Prospective Randomized Comparative Clinical Study

COMPARISON OF EFFICACY OF PPICUD AND INJ. DMPA AS A POSTPARTUM CONTRACEPTIVE METHOD

Intrauterine contraceptive devices are the safest method of contraception available at present. The present study was conducted with the aim to compare the effectiveness of PPICUD and Inj. DMPA as a contraceptive method in 40 postpartum mothers between the age group of 21-25 years. Our study shows that overall acceptance rate and satisfaction was higher in inj. DMPA users (90%) as compared to PPIUCD users (82.5%). Complications are relatively less in inj. DMPA users as compared to PPIUCD users.

The Relationship between the Use of Hormonal Contraceptive Devices on Body Weight of Family Planning Acceptors

Contraception is a way to prevent and space pregnancies as well as to plan the number of children to improve family welfare so that they can provide maximum attention and education to children. The level of contraceptive use or the Contraceptive Prevalance Rate (CPR) in Indonesia was 57% in 2015 to 61.4% in 2018. This study aims to determine the relationship between the use of hormonal contraceptives and the body weight of family planning acceptors. This type of research is a descriptive analytic study with a cross sectional research design. This research was conducted in the working area of the Landawe Health Center in August 2021. The analysis used the Fisher exact test. The results showed that most of the respondents' weight increased by 60%. The results of the analysis show that value is 0.032 &lt; = 0.05, which means that there is a relationship between the use of hormonal contraception and body weight in family planning acceptors.

Levonorgestrel Intrauterine System (MIRENA): Initial Experience in the Management of Abnormal Uterine Bleeding

Introduction: The Levonorgestrel intrauterine system (MIRENA) is a long acting contraceptive device act by releasing progesterone into the uterus It is also efficient in medical management of abnormal uterine bleeding. Levonorgestrel intrauterine system is best option for those ladies who want to avoid surgery in cases of abnormal uterine bleeding.&#x0D; Aims: To assess the effectiveness of MIRENA in abnormal uterine bleeding.&#x0D; Methods: This is a hospital based cross sectional study done at the department of obstetrics and gynecology in ladies with history of abnormal uterine bleeding. The study was done from January 2020 to January 2022 for a period of two years. Data were collected, recorded in standard Proforma and analyzed by using EESPPS version 17.&#x0D; Results: Majority of patients were multipara of age group 35-40 yrs. Mirena caused decrease in heavy menstrual blood loss by 2.4% in 4month of use and 47.6% by one year. After one year of use 83.3% patient had better compliance, 9.5% had expulsion, and only 7.1% had to undergo hysterectomy.&#x0D; Conclusion: Mirena is the best alternative in the medical management of abnormal uterine bleeding with good patient compliance reducing the rate of hysterectomy.

Frequency of Pelvic Inflammatory Disease in Infertile Patients

Aim: Frequency of pelvic inflammatory disease in women presenting with infertility Study design: Cross sectional research Setting: Obstetrics/Gynaecology Deptt., Services Hospital, Lahore from 20-10-2017 to 20-04-2018. Methods: One hundred married females with Infertility (Primary/Secondary) were included in the study. Patients with H/o intrauterine contraceptive devices usage, diabetes, male factor Infertility and H/O pelvic surgery were excluded. All women were taken complete history and detailed physical and gynecological examination and HVS was sent to laboratory for culture. Results: Age was from 20 to 35 years with mean ± SD 29.41±2.35 yrs, mean±SD of weight 70.09±12.66kg, mean±SD height 1.54±0.09 meters, mean ± SD of BMI 29.67±5.09 Kg/m2 and mean±SD duration of Infertility was 2.5±0.97 years. Majority of the patients were from 0-2 parity (92%). Primary infertility was found in 64% women while secondary infertility was 36%. Pelvic Inflammatory Disease was found in 27% patients. Conclusion: Tubal damage before and during the index episode of PID is correlated with infertility. Keywords: Infertility, Pelvic inflammatory disease, Frequency

Morphological Spectrum of Endometrium in Patients with Abnormal Uterine Bleeding

Background: Abnormal uterine bleeding (AUB) is one of the major problems requiring gynecological consultation. Biopsy proved to be gold standard for the accurate diagnosis of abnormal bleeding. It is more frequently observed in perimenopausal females. Aim: To determine morphological spectrum of endometrium in patients of pre and post-menopausal age groups with abnormal uterine bleeding. Study Design: Descriptive-cross-sectional study Place and duration of study: Department of Histopathology, K. E. Medical University Lahore from 31-07-2018 31-01-2019 Methodology: Three hundred and eighty four patients undergoing diagnostic dilatation and curettage or hysterectomy for abnormal uterine bleeding were included. Their demographic features i-e age and address were noted. The biopsies received in Pathology Department were formalin fixed, after tissue processing and cutting the slides were prepared and stained with haematoxylin and eosin stains. Results: There were 311(80.99%) patients between 25-50 years of age whereas 73(19.01%) between 51-60 years of age. Morphological spectrum of endometrium in patients of pre and post-menopausal age groups with abnormal uterine bleeding shows that 71(18.49%) had proliferative morphology, 58(15.10%) had secretary, 37(9.64%) had simple hyperplasia, 56(14.58%) had complex hyperplasia, 17(4.43%) had atrophic endometrium and 145(37.76%) had other type of morphology (may include mechanical causes such as intrauterine contraceptive device and malignancy). Conclusion: Morphological spectrum of endometrium in patients of pre and postmenopausal age groups with abnormal uterine bleeding shows proliferative morphology as the common morphology followed by secretary, simple hyperplasia, and complex hyperplasia. Key words: Abnormal uterine bleeding, Morphological spectrum of endometrium, Proliferative