Intrauterine Contraceptive Device Group Research Articles

Comparison of Complication of Postpartum Intrauterine Contraceptive Device With Interval Placed IUCD

For prevention of unintended and closed interval pregnancies through the first year following childbirth, postpartum family the planning is required. A wide range of reliable and cost-effective contraceptive methods are available for postpartum women. Objective: To compare the frequency of complications of postpartum intrauterine contraceptive device (PPIUCD) versus interval placed intrauterine contraceptive device (IUCD). Methods: It was a randomized control clinical trial which was conducted in Unit 3, Department of Obstetrics & Gynecology, Lady Willingdon Hospital, Lahore. The time period of this study was 6 months extending from January 2018 to June 2018. After fulfilling the inclusion criteria, 160 patients were enrolled in the study. These patients were followed up for time period of 6 months in both groups. The complications named perforation, pelvic infection and expulsion were noted. All the gathered information regarding variables was analyzed on SPSS version 20.0. Results: The mean age and gestational age of females of the PPIUCD group was 26.50±5.05 years and 38.94±1.42 weeks and interval IUCD group was 28.25±4.40 years and 39.08±1.29 weeks respectively. In this study the pelvic infection was noted in 8 females in which 2 were from PPIUCD group and 6 were from interval IUCD group. Statistically insignificant difference was found between the study groups with pelvic infection i.e. p-value=0.147. Expulsion was noted in 1 female from PPIUCD group and 3 females from interval IUCD group. The difference was insignificant (p>0.05). Conclusions: There was no statistical difference found in frequency of complications with PPIUCD versus interval placed IUCD.

Effects of injectable progestogen contraception versus the copper intrauterine device on HIV acquisition: sub-study of a pragmatic randomised controlled trial

BackgroundEvidence from observational studies suggests an increased risk of HIV acquisition among women using depot medroxyprogesterone acetate (DMPA) contraception.MethodsWithin the context of a South African programme to increase women's access...

Randomized, controlled trial comparing the efficacy of intrauterine balloon and intrauterine contraceptive device in the prevention of adhesion reformation after hysteroscopic adhesiolysis

To compare the efficacy of heart-shaped intrauterine balloon and intrauterine contraceptive device (IUD) in the prevention of adhesion reformation after hysteroscopic adhesiolysis. Prospective, randomized, controlled trial. University hospital. A total of 201 women with Asherman syndrome. Women were randomized to having either a heart-shaped intrauterine balloon or an IUD fitted after hysteroscopic adhesiolysis. The devices were removed after 7days. A second-look hysteroscopy was carried out 1 to 2months after the surgery. Incidence of adhesion reformation and reduction of adhesion score before and after surgery. Initially 201 cases were recruited; 39 cases dropped out, resulting in 82 cases in the balloon group and 80 cases in IUD group. The age, menstrual characteristics, pregnancy history, and American Fertility Society score before surgery were comparable between the two groups. The median adhesion score reduction (balloon group, 7; IUD group, 7) and the adhesion reformation rate (balloon group, 30%; IUD group, 35%) were not significantly different between the two groups. The heart-shaped intrauterine balloon and IUD are of similar efficacy in the prevention of adhesion reformation after hysteroscopic adhesiolysis for Asherman syndrome. ISRCTN 69690272.

Five-year follow-up of two types of contraceptive device fitted during elective cesarean delivery

ObjectiveTo present follow-up data for patients fitted with a copper intrauterine contraceptive device (IUCD) or the levonorgestrel intrauterine system (IUS) during cesarean delivery. MethodsBetween March 2006 and December 2011, a prospective study was undertaken of women who were scheduled to have a repeat cesarean for a singleton pregnancy and had chosen to undergo intraoperative fitting of an IUCD or the IUS. Participants were followed up for up to 5years using transvaginal ultrasonography, clinical evaluation, and a questionnaire. ResultsAmong 143 participants, 63 requested the IUCD and 80 the IUS. Misalignment was more common at 6weeks with the IUS (37 [46.3%] patients) than with the IUCD (22 [34.9%]; P=0.06). Spontaneous expulsion occurred in the IUCD group only (4 [6.3%] patients). No pregnancies were reported in the IUS group, whereas 4 (6.3%) women with the IUCD became pregnant. ConclusionAlthough misalignment of an IUCD or the IUS is fairly common after intraoperative insertion, the contraceptive performance and menstrual pattern are not affected. Therefore, there is no need to remove or replace a misaligned IUCD or IUS.

Safety and acceptability of intrauterine balloon stent used in uterine after hysteroscopic adhesiolysis to prevent adhesion reformation

To evaluate the safety and acceptability of COOK intrauterine balloon stent in uterine for one week after hysteroscopic adhesiolysis. A total of 79 females with moderate-severe Asherman syndrome undergoing hysteroscopic division of intrauterine adhesion were enrolled from June 2012 to December 2013. They were divided into two groups of intrauterine balloon stent (n = 51) and tailed intrauterine contraceptive device (n = 28). The sterile swabs were taken from cervical canals for bacterial culture by the same microbiologist. Each patient in balloon group was requested to answer a questionnaire survey on the acceptability of balloon stent. 82.3% of them could tolerate discomforts during balloon placement and 86.3% desired re-ballooning if necessary. Positive microorganism cultures were seen in 17 patients (33.3%) in balloon group versus 8 (28.6%) in intrauterine contraceptive device group. And the positive rate was not different between two groups. It is relatively safe to maintain the intrauterine balloon stent in uterine for one week. And most patients accept readily the intrauterine balloon stent.

A comparison of intrauterine balloon, intrauterine contraceptive device and hyaluronic acid gel in the prevention of adhesion reformation following hysteroscopic surgery for Asherman syndrome: a cohort study

ObjectiveTo compare the efficacy of intrauterine balloon, intrauterine contraceptive device and hyaluronic acid gel in the prevention of the adhesion reformation after hysteroscopic adhesiolysis for Asherman's syndrome. Study designRetrospective cohort study of 107 women with Asherman's syndrome who were treated with hysteroscopic division of intrauterine adhesions. After hysteroscopic adhesiolysis, 20 patients had intrauterine balloon inserted, 28 patients had intrauterine contraceptive device (IUD) fitted, 18 patients had hyaluronic acid gel instilled into the uterine cavity, and 41 control subjects did not have any of the three additional treatment measures. A second-look hysteroscopy was performed in all cases, and the effect of hysteroscopic adhesiolysis was scored by the American Fertility Society classification system. ResultsBoth the intrauterine balloon group and the IUD group achieved significantly (P<0.001) greater reduction in the adhesion score than that of the hyaluronic acid gel group and control group. The efficacy of the balloon was greater than that of the IUD (P<0.001). There was no significant difference in results between the hyaluronic acid gel group and the control groups. ConclusionThe insertion of an intrauterine balloon or intrauterine device is more effective than the use of hyaluronic acid gel in the prevention of intra-uterine adhesion reformation.

A random control study of indomethacin-containing MYCu intrauterine contraceptive device for 60 months

To explore the clinical efficacy and safety of MYCu intrauterine contraceptive device (IUD) containing indomethacin. From October 1 to December 31, 2004, women of child-bearing age requiring IUD for contraception were chosen from the Outpatient Departments of China-Japan Friendship Hospital of Jilin University, Peking University First Hospital, Peking University Third Hospital, Jilin University Second Hospital and Affiliated Shengjing Hospital of China Medical University. They were randomly inserted with MYCuIUD and control TCu380A IUD each for 1000 cases and followed up at 1, 3, 6, 12, 24, 36, 48 and 60 months post-insertion. When MYCu IUD group and TCu380A group 60 months post-insertion were compared, the cumulative pregnancy rates with IUD in situ were 2.38/100 women per year and 2.84/100 women per year respectively. And the difference had no statistical significance (P > 0.05); the cumulative expulsion rates, mostly of partial expulsion and downward movement, were 0.87/100 women per year and 2.94/100 women per year respectively. And the difference had statistical significance (P < 0.05); the cumulative termination rates due to bleeding/pain were 3.57/100 women per year and 4.83/100 women per year respectively. And the difference had no statistical significance (P > 0.05); Side effects in MYCu group were less pronounced than those in TCu group. And the inter-group differences had statistical significance (P < 0.05). As a comparatively ideal medicated medical device, MYCu IUD has an excellent contraceptive efficacy, a low rate of expulsion and side effects and good reversibility. Particularly a low occurrence rate of bleeding and pain during early insertion is recommended. Its life expectancy is 15 years. And its contraceptive effectiveness and safety after 5 years should be examined during further follow-ups.

Puerperal and menstrual bleeding patterns with different types of contraceptive device fitted during elective cesarean delivery

Objective To evaluate the impact of a copper-containing intrauterine contraceptive device (IUCD) and the levonorgestrel-releasing intrauterine system (IUS) on puerperal and menstrual bleeding when fitted intraoperatively during scheduled elective cesarean. Methods Participants were allocated to 3 groups: cesarean with no device inserted; IUCD inserted during cesarean; and IUS inserted during cesarean. Results There was significantly shorter and lighter puerperium in the IUS group (20.2 ± 7.7 days and 3.1 ± 1.6 pads/day) than in the IUCD (33.4 ± 9.5 days and 4.9 ± 2.4 pads/day) and the control (27.0 ± 11.4 days and 4.9 ± 2.3 pads/day) groups ( P < 0.012 and P < 0.0001, respectively). At the end of puerperium, mean duration of amenorrhea was significantly longer in the IUS group than in the IUCD and control groups ( P < 0.0001). Menstrual periods were longer and heavier in the IUCD group than in the control group but the difference was not significant ( P > 0.07). In the IUS group, menstrual periods were significantly shorter and lighter than in the other groups ( P < 0.0001). Conclusion Intrauterine system fitting at the time of elective cesarean is associated with significant reductions in the duration and amount of puerperal blood loss, as well as a high incidence of amenorrhea and lighter periods thereafter.

A comparison of two adjunctive treatments for intrauterine adhesions following lysis

Objectives: To assess which treatment modality has a better outcome: the use of an intrauterine contraceptive device or the Foley catheter balloon, for the adjunctive treatment of intrauterine adhesion (IUA) in patients presenting with infertility. Methods: In a 4-year initial period, patients with intrauterine adhesion were treated with the insertion of an intrauterine contraceptive device (IUCD) after adhesiolysis. In the next 4 years, a pediatric Foley catheter balloon was used after adhesiolysis instead of the IUCD. The postoperative treatment was the same throughout the 8 years. While the IUCD was removed after three consecutive withdrawal vaginal bleedings, the Foley catheter was removed after 10 days. Hysterosalpingography was repeated in all patients after the third withdrawal vaginal bleeding, and the procedure was repeated if the intrauterine adhesion still persisted. The χ 2-test was used for analysis. Results: There were 51 cases of IUA treated with the IUCD and 59 cases treated with the Foley catheter balloon. In the Foley catheter group, 81.4% of the patients had restoration of normal menstruation compared with 62.7% in the IUCD group ( P<0.05). Persistent posttreatment amenorrhea and hypomenorrhea occurred less frequently in the Foley catheter group (18.6%) than in the IUCD group (37.3%) ( P<0.03), and the conception rate in the catheter group was 33.9% compared with 22.5% in the IUCD group. The need for repeated treatment was also significantly less in the Foley catheter group. Conclusion: The Foley Catheter is a safer and more effective adjunctive method of treatment of IUA compared with the IUCD.

Mifepristone as a late post-coital contraceptive.

This study was undertaken to assess the efficacy of mifepristone as a post-coital contraceptive beyond 72 h and up to 5 days in women who found the intrauterine contraceptive device (IUCD) unacceptable. During a 2 year period 219 consecutive women fulfilling the inclusion criteria and presenting late for emergency contraception were approached and offered a choice of methods. Fifteen (6.8%) women wished to have the IUCD fitted, but 204 (93.2%) who found this unacceptable were offered and accepted mifepristone 200 mg. In one woman there was a technical problem fitting the IUCD and mifepristone was administered. Women who had mifepristone were younger (mean age 21.4 versus 26.9 years, P = 0.004) and more likely to be nulliparous (81 versus 25 %, P < 0.001) than the IUCD group. A total of 155 (75.6%) women who had mifepristone and all 14 who had the coil fitted were followed up. There were no true failures in either group. There was one user failure in the mifepristone group, where pregnancy occurred from an act of intercourse subsequent to treatment, giving a crude pregnancy rate of 0.65%. Mifepristone prevented 85% of expected pregnancies. Most women find the IUCD an unacceptable method of post-coital contraception. Mifepristone is an effective late post-coital contraceptive, which can be offered to women who decline the IUCD.

The use of nomegestrol acetate subdermal contraceptive implant, uniplant, during lactation

Uniplant is a single contraceptive implant intended for one year use. It contains the progestogen nomegestrol acetate. The clinical performance and the effect of its use during the first postpartum year on breastfeeding performance and growth and health of the infants were studied and compared to the findings in a parallel group who used an intrauterine contraceptive device (IUD) in a prospective, non-randomized study. This was carried out in Assiut, Egypt. Two-hundred-forty fully breastfeeding mothers asking for initiation of contraception early postpartum were assigned according to their choices into either nomegestrol subdermal contraceptive implant (Uniplant) (120 women) or intrauterine contraceptive device (CuT 380A) (120 women). The mother and infant pairs were followed up at monthly intervals during the first three months and at two-month intervals thereafter up until the first birthday of the baby. No pregnancy occurred in the two groups. Amenorrhea was significantly more prolonged in the Uniplant group than in the IUD group. There were no significant differences in net continuation rates between the two groups (88.3 versus 92.4 per 100 women, respectively). There were no significant differences between the two groups in the number of breastfeeding episodes, time of weaning, and the cumulative rates of full and partial breastfeeding. There were no significant differences between the two groups in infant weight, weight gain per day, or in infant linear growth. There were no significant differences in the incidence of important health problems affecting the infants of the two groups. However, there were seven infant deaths, six of them were in the Uniplant group. Uniplant subdermal contraceptive implants can be offered as a new contraceptive option suitable for nursing mothers.

Transdermal estrogen with a levonorgestrel-releasing intrauterine device for climacteric complaints: Clinical and endometrial responses

OBJECTIVE: Our purpose was to study the effects of intrauterine release of a daily dose of 20 μg levonorgestrel by an intrauterine device on climacteric symptoma, bleeding pattern, and endometrial histologic features in postmenopausal women receiving transdermal estrogen replacement therapy. STUDY DESIGN: Forty parous postmenopausal women were randomly allocated into two groups for 1 year: 20 women receiving a continuous transdermal daily dose of 50 μg of estradiol had a levonorgestrel-releasing intrauterine contraceptive device inserted, and the control group of 20 women received a continuous oral dose of 2 mg of estradiol valerate and 1 mg of norethisterone acetate daily. The climacteric symptoms, bleeding patterns, endometrial thickness, and endometrial changes in biopsy samples were analyzed. Serum levels of estradiol in both groups and levonorgestrel levels in the intrauterine device group were also determined. RESULTS: Both treatment regimens effectively relieved climacteric symptoms. Spotting was more common in the intrauterine contraceptive device group than in the oral therapy group for the first 3 months. After that, the proportion of women without any bleeding was similar in both groups. Two patients in each group dropped out because of bleeding. CONCLUSION: These preliminary findings suggest that the levonorgestrel-releasing intrauterine contraceptive device is a useful alternative mode of progestin administration for certain selected women receiving estrogen replacement therapy.