Use Of Intrauterine Contraceptive Device Research Articles

Comparative analysis of endometrium after using levonorgestrel-releasing intrauterine system and copper intrauterine device

BACKGROUND: To date, the risks of pelvic inflammatory diseases, including chronic endometritis, associated with the use of various intrauterine contraceptives, have remained debatable. AIM: The aim of this study was to conduct a comparative analysis of the endometrial status in women of reproductive age after the use of copper- or levonorgestrel-releasing intrauterine device. MATERIALS AND METHODS: Morphological and immunohistochemical studies of endometrial biopsies obtained by aspiration Pipelle biopsy were performed after intrauterine device extraction in 18 patients who used a copper-containing intrauterine device and in 12 women who used the levonorgestrel-releasing intrauterine device Mirena. Monoclonal mouse antibodies to CD20, CD138, and α-smooth muscle actin (DAKO, Denmark) were used. Criteria for inclusion of patients in the study are reproductive age, use of an intrauterine device for five years, absence of complications associated with the intrauterine device during its use. Exclusion criteria are a history of pelvic inflammatory diseases, sexually transmitted infections, habitual miscarriage, two or more intrauterine interventions. RESULTS: After using a copper-containing intrauterine device, signs of chronic inflammation were found in the endometrium such as cytogenic stroma fibrosis with pronounced infiltration by inflammatory cells, positive expression of CD138 (33.3% of observations), CD20 (88.9% of observations with an average number of 27.4 ± 5.7), α-smooth muscle actin (up to 70% of the cytogenic stroma area), and the presence of lymphatic follicles consisting of B lymphocytes (33.3% of observations). During the use of the levonorgestrel-releasing intrauterine device, decidual transformation of cytogenic stroma cells, as well as secretion and atrophy of the glandular epithelium, were found in the endometrium. CD20-positive cells were detected in five out of 12 cases (41.6% of observations with an average number of 12.8 ± 4.6). Expression of CD138 and α-smooth muscle actin was not detected in any of the cases. CONCLUSIONS: The use of a copper-containing intrauterine device is associated with a high risk of developing chronic endometritis. The absence of signs of chronic inflammation in the endometrium after the use of a levonorgestrel-releasing intrauterine device is probably due to the protective effect of levonorgestrel on the uterine mucosa. Thus, levonorgestrel-releasing intrauterine devices, in comparison with copper-containing intrauterine devices, have a favorable safety profile relative to the endometrium and can be recommended for women of reproductive age, including those who have not given birth.

CORRELATION RATIO OF CHRONIC ENDOMETRITIS WITH ANAMNESTIC FACTORS AND ULTRASOUND CHARACTERISTICS OF THE ENDOMETRIUM IN WOMEN OF REPRODUCTIVE AGE

The diagnosis of chronic endometritis is problematic because of its asymptomatic course and the need for invasive uterineprocedures to confi rm the diagnosis histologically. Therefore, it is important to identify factors that indicate a high risk of this condition. Aim: The aim of this study is to identify factors that have a statistically signifi cant correlation with the presence of CE in women of reproductive age and to validate them by histologic examination of the endometrium.Material and Methods. A retrospective analysis of 400 histories of women of reproductive age who underwent hysteroscopyand endometrial biopsy for histologic examination was performed. Histologically, 154 women (38.5 %) were found to havechronic endometritis (the group of women with chronic endometritis), while 246 women (61.5 %) were found to have otherconditions unrelated to chronic endometritis (the group of women without chronic endometritis). Analysis of anamnestic factors and ultrasound criteria associated with an increased likelihood of chronic endometritis was performed when comparing data from women in these groups. The strength of the relationship between these factors on the one hand and the development of chronic endometritis on the other hand was assessed by calculating the Kendall’s τ (tau) rank correlation coeffi cient. The strength of the relationship between the mentioned factor and CE was considered strong (+++) with a τ coeffi cient of 0.5 or higher, moderate (++) with a τ coeffi cient in the range of 0.2 to 0.499, weak (+) with a τ coeffi cient in the range of 0.1 to 0.199. A τ-coeffi cient value between 0 and 0.099 indicated no correlation between the factor and chronic endometritis.The study was conducted in accordance with the principles of patient- centered care, the requirements of the Tokyo Declaration of the World Medical Association, the international recommendations of the Helsinki Declaration of Human Rights, the Convention of the Council of Europe on Human Rights and Biomedicine, the laws of Ukraine, and the Code of Ethics of the Ukrainian Physician.The paper is an excerpt from the initiative scientifi c research project of the Department of Obstetrics and Gynecology No.2 at Poltava State Medical University, entitled «Optimization of approaches to the management of pregnancy in women at high risk of obstetric and perinatal pathology» (State registration number 0122U201228, duration: 10.2022-09.2027) in collaboration with the Department of Pathological Physiology at Poltava State Medical University.Results and Discussion. The determination of the correlation coeffi cient allowed us to identify the factors with the strongestassociation with chronic endometritis. Among them are 5 infectious factors: cervicitis in the past medical history (τ coeffi cient 0.625245229; p<0.0000000001); chronic infl ammation of the uterine appendages (τ coeffi cient 0.522536031; p<0.0000000001); sexually transmitted diseases in the past medical history (τ coeffi cient 0.547218916; p<0.0000000001); chronic urogenital infl ammatory diseases in the sexual partner (τ coeffi cient 0. 529314979; p<0.0000000001); previous multiple use of intrauterine contraception (τ-coeffi cient 0.502383401; p<0.0000000001); 4 symptomatic consequential factors: infertility in past medical history (τ-coeffi cient 0.683492482; p<0.0000000001); missed miscarriages in past medical history (τ-coeffi cient 0. 644489429; p<0.0000000001); recurrent early pregnancy loss (τ-coeffi cient 0.625942138; p<0.0000000001); abnormal uterine bleeding (τ-coeffi cient 0.650850348; p<0.0000000001); and 4 ultrasound criteria, such as the presence of local endometrial thickening in the form of a polyp (τ-coeffi cient 0.641820318; p<0. 0000000001); increased echogenicity of the endometrium (τ-coeffi cient 0.665249637; p<0.0000000001); heterogeneity of the endometrial echo structure with areas of increased and decreased echogenicity (τ-coeffi cient 0.693152163; p<0.0000000001); hyperechogenic structures in the basal layer of the endometrium (τ-coeffi cient 0.521658745; p<0.0000000001). In our opinion, the combination of an infectious or symptomatic factor with an ultrasound criterion indicates a high probability of chronic endometritis. In the absence of ultrasound signs, the combination of 1 infectious and 1 symptomatic- consequential factor indicates a high risk of chronic endometritis. To confirm the representativeness of this method, we analyzed endometrial biopsies obtained by curettage in 100 women with this combination of factors. The diagnosis was confi rmed histologically in 87 women. Conclusion. Our proposed assessment of high-risk criteria for chronic endometritis, based on the combination of infectious,symptomatic- consequential, and ultrasound criteria, allows predicting the presence of this pathology in 87 % of patients withoutтthe need for invasive interventions. This helps to improve patient selection for hysteroscopy and avoid unnecessary uterine interventions in the diagnosis of chronic endometritis in women planning pregnancy.

Pregnant mothers intention to use postpartum intrauterine contraceptive device and its associated factors in Arba Minch Town, Southern Ethiopia, 2022

IntroductionPostpartum intra-uterine device use contributes to the happiness and health of women, children, and families who are of reproductive age. Out of the 210 million pregnancies that happen worldwide each year, about 80 million are unintended. Increasing postpartum intrauterine contraceptive device intention can help reduce unplanned pregnancies and the incidence of abortion. Methodsa cross-sectional study was conducted in pregnant mother’s home from March to April 2022 to assess the intension to use PPIUCD and to identify factors. Through simple random selection, 482 pregnant women were surveyed using a pretested, structured questionnaire and in-person interviews. Four randomly selected Kebeles were involved in the study by using simple random sampling. The data was imported into Epi-data version 4.6.0.2 and then analysed using Stata version 14. Bivariate and multivariable logistic regressions were used to identify associated factors. Results482 pregnant women have participated in the study, and 98.5 % of them responded. 13.7 % (95 % CI: 11.0–17.0) of the participants stated that they planned to use an intra-uterine devices after giving birth. The intention to use a postpartum intrauterine contraceptive device had a significant association with the participants' educational level (AOR = 4.69; 95 % CI: 1.31–16.81), moderate level (AOR = 3.77; 95 % CI: 1.90–7.50), high knowledge (AOR = 4.82; 95 % CI: 1.96–11.87), and favorable attitude (AOR = 7.26; 95 % CI: 3.39–15.52), according to the results of the multivariable analysis. ConclusionIn Ethiopia, compared to earlier research, there was a decreased intention to use postpartum intrauterine contraceptive devices. Encouraging the use of postpartum intrauterine contraceptives for social and behavioural changes can be more effective.

Prevalence of cervical intraepithelial lesions and associated factors among women attending a cervical cancer clinic in Western Uganda; results based on Pap smear cytology.

There are high incidence and mortality rates of cervical cancer among females in East Africa. This is exacerbated by limited up-to-date data on premalignant lesions and associated factors in this setting. In this study, we determined the prevalence of cervical intraepithelial lesions and associated factors among women attending the Mbarara Regional Referral Hospital cervical cancer clinic in Southwestern Uganda. In this cross-sectional study, 364 participants were recruited from among women attending the Mbarara Regional Referral Hospital cervical cancer clinic from 1 April to 30 June 2023. On consent, the study nurse collected demographic data and Pap smears, which were microscopically examined and reported by a laboratory scientist and a pathologist following the Bethesda grading system (2014). Statistical analyses were done in STATA version 17, using proportions, Chi-square, bivariate, and multivariate logistic regression analysis to determine associated factors at ⩽0.05 significance level. The mean age of participants was 41.9 years. A third of all study participants (37.6%, 132/351) were contraceptive users, mostly hormonal contraceptives (87.1%, 115/132). Almost 88% (307/351) had an unknown Human Papilloma Virus status. The prevalence of cervical intraepithelial lesions among our study participants was 6.6% (23/351), of which 73.9% (17/23) were low-grade squamous intraepithelial lesions. More than half (9/17, 52.9%) of low-grade squamous intraepithelial lesions were active hormonal contraceptive users. Use of hormonal contraceptives (OR: 3.032, p: 0.0253), use of intrauterine devices (OR: 6.284, p: 0.039), and any family history of cervical cancer (OR: 4.144, p: 0.049) were significantly associated with cervical intraepithelial lesions. The prevalence of cervical intraepithelial lesions was 6.6%, lower than global estimates. Use of hormonal and intrauterine device contraceptives, as well as family history of cervical cancer, were significantly associated with cervical intraepithelial lesions among our study population. Prospective studies are recommended to further understand associations between different types of intrauterine devices and hormonal contraceptives, and cervical lesions.

Correlation Between Vulva Hygiene And Intrauterine Device Use And The Event Of Vaginal Discharge In Women Of Reproductive Age

Pathological leucorrhoea is an abnormal disorder in women of childbearing age that occurs in the body in the form of thick white, yellowish, greenish discharge. This is because the composition of the vaginal microflora fluctuates as a function of internal factors such as age,hormonal changes during menarche,menstruation,and pregnancy. External factors such as hygiene practices, sexual relations, and contraceptive use.In the use of Intrauterine devices, there is vaginal discharge that occurs as a result of the initial reaction to the presence of a foreign body, the use of intrauterine contraceptives which can change the chemical balance of the vagina and is thought to cause vaginitis. The research method for this literature review analyzed 8 research articles and assessed the articles based on predetermined inclusion and exclusion criteria. This literature reviews various risk factors that influence the occurrence of vaginitis due to the use of non-hormonal intrauterine contraceptive devices that occur in women of childbearing age and through good vulva hygiene behavior,can reduce the risk of physiological and pathological vaginal discharge.Based on these sources,it can be concluded that there is a relationship between vulva hygiene and the use of Intrauterine device with the incidence of vaginal discharge in women of childbearing age.

Why Pakistani Women Do Not Use Intrauterine Contraceptive Devices: A Systematic Review of Barriers and Misconceptions.

This review explores barriers limiting the adoption of Intrauterine Contraceptive Devices (IUCDs) in Pakistan, focusing exclusively on local articles. As Pakistan's high population calls for widespread contraception, we aim to pinpoint obstacles hindering IUCD utilization, irrespective of parity. We conducted a comprehensive search of PubMed, Google Scholar, PakMedinet, and Wiley Online Library for English-language primary studies published between 2000 and 2022, reporting on IUCD utilization in Pakistan. Our analysis reveals multiple barriers impeding IUCD use in Pakistan. These encompass patriarchal social norms, male dominance, low education, socioeconomic status, and unemployment. Post-insertion health concerns, inadequate counseling, government commitment, and awareness were also identified barriers. Provider confidence, client trust, women's autonomy, social constraints, and limited male partner involvement hindered IUCD adoption. A desire for larger families and male offspring, vague religious beliefs, fear, and misconceptions further restricted usage. Accessibility and high service costs also posed challenges. This review highlights prevailing impediments to IUCD adoption in Pakistan, encompassing knowledge gaps, motivation deficits, resistance from husbands and in-laws, cultural and religious beliefs, limited access, and communication barriers. To promote IUCDs as a modern contraceptive method, it is essential to raise awareness among both men and women. Active involvement of religious leaders and community stakeholders is crucial in addressing these social factors hindering IUCD utilization.

A descriptive study to assess the knowledge and attitude regarding birth spacing and use of IUCD as a temporary family planning method among the married women of selected rural area of Byahatti PHC, Dharwad district with a view to develop informational booklet

Human fertility is determined by several factors like age at marriage, customs, education, etc. In India, reproductive age group women are more than 248 million. Therefore, Government of India introduced several policies on family planning and recognized the importance of contraception. Intrauterine contraceptive devices (IUCDs) have been successfully used by Indian women; however, still there are some disbeliefs and misconceptions regarding its usage and also Birth Spacing is very important in child growth and development. A descriptive study was conducted among 60 married womens of selected rural area of Hubballi. The samples were selected using Non-Probability; Purposive Sampling Technique. Data was collected by interview schedule and attitude scale. Data analysis was done using descriptive and inferential statistics. Overall results of the study revealed that out of 60 subjects, 13 (22%) had good knowledge, 38 (63%) had average knowledge, and 9 (15%) had poor knowledge regarding birth spacing and use of IUCD as a temporary family planning method. In terms of attitude 14 (23%) had positive attitude, 42 (70%) had neutral attitude, and 04 (7%) had negative attitude towards birth spacing and use of IUCD as a temporary family planning method.

Internal vaginal douching increases the incidence of vaginal infection among IUD users: a cross-sectional study

BackgroundWe compared the rate, type and severity of vulvovaginitis in women who are practicing internal vaginal douching (IVD) or not while using an intrauterine contraceptive device (IUCD).It is a cross-sectional study on 604 consecutive attendees of the outpatient clinics using IUCD for at least 6 months prior to recruitment. Eligible participants were divided into two groups: group 1 (302 women) performing IVD and group 2 (302 women) not practicing this habit (NIVD). The frequency of vaginal infections in IUCD users who perform IVD compared to women who were abstaining from this habit was our primary outcome.ResultsThey are IUCD users who were practicing IVD more frequent history of vaginal infection (VI) compared with NIVD-IUCD users [260 (88.1%) versus 151(43.4%); respectively] (P < 0.001). Current diagnosis of VI was significantly higher in IVD group (275; 91.05%) compared to NIVD group (115; 38.1%) (P < 0.001). Bacterial vaginosis was the most common infection (287; 47.5%) followed by candida vulvovaginitis (278; 46.03%). Moreover, both types of infections were significantly more common in IVD.ConclusionThe use of IUCD may not increase occurrence of vulvovaginitis, but IVD does increase vaginal infection rate either with or without IUCD use. When vaginal infection happens with IUCD, BV is the most common type of infection followed by Candida albicans.

Barriers and Acceptance of Intrauterine Contraceptive Devices (IUCD) Among Married Women of Reproductive Age in Odisha, India.

The Copper-T (Cu T-380 A), an intrauterine contraceptive device (IUCD), is widely available and is a highly effective, safe, long-term, and reversible method of contraception. Despite this fact, there is low utilization of IUCDs in India. Hence, this study focused on determining the rate of acceptability of IUCDs, identifying barriers to acceptance of IUCDs, and finding out the cause of IUCD discontinuation. A hospital-based cross-sectional study was conducted among 720 married women in the Khordha district, Odisha, India, via a questionnaire and a structured interview schedule. A systematic random sampling method was applied to select the participants. A multivariate logistic regression test was used to determine the factors associated with the acceptance of IUCDs. This study revealed that only 20.97% of the potential users were currently using IUCDs, 73.75% had never used n IUCD as a contraceptive, and 20.1% of women had discontinued it. Multiple socio-demographic, obstetrical, and family planning behaviours and a lack of awareness were identified to be linked to IUCD acceptability.Fear of adverse effects, family members' objections, availability of other modern contraceptive methods, husband's disagreement, and lack of awareness about the benefits of IUCDs were the most stated reasons for refusal of IUCDs. The most common reason for discontinuing an IUCD was the desire for another child. The rate of acceptability of IUCDs was quite low in Odisha as compared to other parts of India and, therefore, this study recommends imparting counselling on effective methods of family planning to increase the acceptance of IUCD use.

СОВРЕМЕННЫЙ СОЦИО-СОМАТИЧЕСКИЙ ПОРТРЕТ ЖЕНЩИНЫ С ПАТОЛОГИЧЕСКИМ КЛИМАКСОМ

Introduction. Nowadays, the number of menopausal women in the world population has strong tendency to increase. According to statistics the majority have a moderate and severe course of it. This is the reason preventive gerontology develops today, especially climatology. That is why using new machine learning technologies is relevant today. Such method as gradient boosting helped us to identify the characteristic features and factors that cause the pathological course of menopause in women which made it possible to draw up a medical «portrait» of such patients. Using the knowledge of these factors influence it is easily to recognize women needs to be observed even before the manifestations of menopause. Aim. The aim of the study is to conduct a socio-somatic «portrait» of a modern patient with a pathological menopause. Material and methods. A detailed survey of 1275 women aged 45–60 years was carried out with an assessment of the socio-cultural status, general somatic and gynecological health. The received data were sorted and categorized using modern statistical processing methods and machine learning method - gradient boosting. Results and discussion. Firstly, there are factors with high influence on menopausal syndrome developing: level of education, oncological anamnesis, diseases of the gastrointestinal tract, vegetative and insomnia disorders, the use of intrauterine contraceptives, the number of children 2 or more, the presence of abortions in anamnesis. The rest of the questionnaires were characterized as having only a small impact. This is a pathology of the thyroid gland, the cardiovascular system; hyperplastic processes in history; occupation, namely social and medical workers, as well as a negative attitude towards menopause. The greater number of these features one woman has, the higher the likelihood of developing a pathological menopause she gets. Conclusion. The collective image we have received of a modern patient with pathological menopausal syndrome is based on aspects of the life and health of women which it is worth paying attention on. This can serve as a kind of guideline for clinicians in order to achieve correction of hypoestrogenism with the development of a pathological menopause.

Association Between Previous Cesarean Section and Subsequent Ectopic Pregnancy: A Comparative Observational Study

Background: The rise in cesarean delivery rates across the world has raised concerns about its potential impact on the outcome of subsequent pregnancies. Among the concerns is the increased risk of ectopic pregnancy, particularly in the tubal or scar site. This study aimed to assess the connection between previous cesarean delivery and subsequent ectopic pregnancy. Methodology: This is a comparative observational study conducted over a period of 1.5 years at Lalla Ded Hospital in Srinagar. The study recruited 148 cases with clinical symptoms of ectopic pregnancy and confirmed diagnosis, along with 4852 matched controls with intrauterine pregnancies. The inclusion criteria comprised women with a previous history of normal vaginal delivery or cesarean section. Patients with a history of ectopic pregnancy, pelvic inflammatory disease, abortions, tubal pathology or surgery, ARTs, and use of intrauterine contraceptive devices were excluded. The data were analyzed using SPSS version 20.0. Results: Out of the 148 eligible cases, 106 (4.2%) had a previous cesarean section, and 42 (1.7%) had a normal vaginal delivery. The odds ratio for women with a previous cesarean section was 2.59 (95% confidence interval= 1.81 to 3.75), which means that they had a 2.59 times higher risk of having subsequent ectopic pregnancy than those with normal vaginal delivery. Conclusion: The study concludes that a previous cesarean section is linked to an increased risk of subsequent ectopic pregnancy. Women with a history of cesarean section should receive close monitoring during early pregnancy to detect and manage ectopic pregnancy promptly. Further research is necessary to identify the underlying mechanisms and develop strategies to reduce the risk of ectopic pregnancy in these women. Keywords: cesarean delivery, ectopic pregnancy, long-term morbidity, risk factors

Use of postpartum intrauterine contraceptive device among women in northern Uganda: A cross‐sectional study

AbstractIntroductionThe aim of this study was to determine the prevalence and factors associated with postpartum intrauterine contraceptive device use among postpartum mothers in Lira district, northern Uganda.MethodsWe designed a cross‐sectional study among postpartum mothers with the outcome as postpartum intrauterine contraceptive device use defined as the insertion of an intrauterine contraceptive device within 10 min to 48 h following placental delivery. Data were collected using a researcher‐administered structured questionnaire. We descriptively summarized numerical data using the mean and the standard deviation and categorical data using frequency and percentages. We performed bivariate analysis using either the χ2 test or Fisher's exact test, and determined factors associated with the outcome using binary logistic regression analysis at a 5% level of statistical significance. We reported the results as adjusted odds ratio (aOR) and 95% confidence interval (CI).ResultsOf 384 postpartum women studied, 37 (9.6%) had used a postpartum intrauterine contraceptive device and the associated factors included maternal age &lt;35 years with an aOR of 0.12 (95% CI: 0.02, 0.72), parity ≥3 with aOR of 4.25 (95% CI: 1.79, 11.03), at least secondary level of education with aOR of 0.27 (95% CI: 0.07, 0.92) and knowledge of adverse effects of a postpartum intrauterine contraceptive device with aOR of 9.56 (95% CI: 4.13, 24.36).ConclusionsThe prevalence of postpartum intrauterine contraceptive device use is low in this setting. Interventions to improve the use of a postpartum intrauterine contraceptive device such as health education should target younger and multiparous women including those without adequate knowledge about it.

Factors Related to Use KB Participants are Active in Understanding Contraceptive Devices (IUD) UPT Working Area DPPKB Bandar District, Simalungun Regency

Based on a preliminary survey conducted in the working area of UPT. DPPKB found that the use of Intrauterine Contraceptive Devices (IUD) was still small compared to other contraceptive methods. Meanwhile, IUD use has begun to be targeted every year. The purpose of this research is to find out what are the factors associated with IUD use. This type of research is quantitative research that is analytic in nature. This research was conducted in the working area of UPT. DPPKB Bandar District in August 2017. The population in this study amounted to 10,429 people with a sample of 189 people. The instrument used was a questionnaire using the Chi-sguare test and SPSS program assistance. Based on the results of the study it was found that the total number of family planning participants had low education, namely 123 people (65.1 % ). The majority of respondents with low education did not use the IUD as many as 118 people (95.9 % ) while only $ people (4.1%) used it. There is a relationship between education and IUD use (P=0.000&lt;0.05 ). Family planning participants had low knowledge, namely 123 people (65.1 % ). The majority of respondents with low knowledge did not use the IUD as many as 121 people (98.4 % ) while only 2 people (1.6%) used it. There is a relationship between knowledge and use of the IUD (P=0.000&lt;0.05 ) . Family planning participants who did not receive support from their husbands were 175 people (92.6 % ). The majority of respondents who did not receive support from their husbands did not use the IUD as many as 164 people ( 93.7 %) while only 1 person (6.3%) used it. There is a relationship between husband's support and IUD use (P=0.000&lt;0.05 ).

Intrauterine contraceptive discontinuation reasons among female trial participants living with HIV in Cape Town, South Africa: A qualitative analysis.

While young women in South Africa may navigate both HIV infection and pregnancy risks, intrauterine contraceptive (IUC) use is low. Though IUCs have low failure rates, concerns exist about whether the IUC is an appropriate method choice for women living with HIV (WLHIV). In this qualitative study, we explore WLHIVs' experiences of using IUC and reasons for discontinuation. This qualitative study included in-depth interviews (IDIs) with 17 WLHIV who electively discontinued their allocated IUC while participating in a randomized controlled trial comparing the safety of the levonorgestrel intrauterine system (LNG-IUS) and the copper intrauterine device (C-IUD) in Cape Town, South Africa. The transcripts were coded and emergent themes were grouped to examine women's experiences with IUC use and reasons for discontinuation, highlighting experiential differences between the two methods. Women's experience with the allocated IUC related most commonly to bleeding and/or abdominal pain just after insertion. Most C-IUD discontinuers, but only one LNG-IUS discontinuer, complained of pain and/or increased bleeding as the main reason for removal. Three women (two LNG-IUS, one C-IUD) requested removal because they desired pregnancy, while two others discontinued due to fears the IUC was exacerbating non-gynecologic conditions (hypertension, diabetes). Generally, women acknowledged advantages of IUC use and many expressed their desire to continue use if not for the side effects. In the South African context, IUC use for WLHIV should be promoted with specific counseling considerations. Both providers and potential users should receive specific information about potential menstrual-related side effects and countering common misperceptions to enable informed contraceptive decision-making.

Study of acceptability for the use of postpartum intrauterine contraceptive device among women attending government general hospital, Guntur

Study of acceptability for the use of postpartum intrauterine contraceptive device among women attending government general hospital, Guntur

Barriers and facilitators influencing utilization of intrauterine contraceptive device (IUCD) in Zimbabwe.

IUCD (Copper-T) is a safe, effective and long-acting reversible contraceptive and its uptake in Zimbabwe is currently less than 1%. Interventions to improve the uptake of IUCD require evidence on key factors contributing to its low uptake. The study was conducted to identify the gaps and offer opportunities for evidence-based family planning aimed at improving demand for IUCD, supply-side conditions, and influencing attitudes towards IUCD. A descriptive qualitative study design was conducted to explore and understand the perceptions of 169 women, 22 men, 16 community leaders and 20 health care providers regarding the use of IUCDs (Copper-T). In-depth interviews, Key informant interviews and focus group discussions with IUCD users, former IUCD users, and users of modern contraceptives (15-49 years) and men were conducted. Rural women showed reluctance to use IUCD because of myths, misconceptions and fears associated with the method which include barrenness, cancers, birth deformities and pregnancy complications. Negative community perceptions, dominant social norms, religious and socio-cultural beliefs, limited awareness of IUCD among men and weak health service delivery platforms were the major barriers to IUCD uptake in Zimbabwe. Evidence-based strategies on demand generation, supply-side interventions, advocacy and communication for development (C4D) are crucial in improving the uptake and provision of IUCD in Zimbabwe.

Implications of Intrauterine Contraceptive Device on Cervical Health: A Cross-Sectional Study

Abstract Background: Amongst long acting, reversible contraceptives, Intrauterine contraceptive devices (IUCDs) are popularly used. While IUCDs are generally safe and effective, they can sometimes cause cytopathological changes in the cervix and endometrium. The most common cytopathological changes associated with IUCDs include inflammatory response in the endometrium and cervix, which can lead to the formation of granulomas and other inflammatory lesions, squamous metaplasia and endometrial hyperplasia. IUCDs can sometimes cause atypia in the glandular cells of the cervix, which may indicate a precancerous or cancerous condition. Aims and Objectives: This study was aimed at cytopathologic changes seen in cervicovaginal smears in IUCD users. Material and Methods: This descriptive, cross-sectional study was conducted in a tertiary care hospital over a period of 1 year. Results: In this study, maximum number of IUCD users belonged to age group 21 to 30 years and parity wise maximum number of patients were in P-2 group (65.78%). As duration of Cu-T increased, incidence of infection was found to be increased. The most frequent chief presenting complaint was excessive discharge per vaginum (49.13%). In our study specific causes of cervical infection in UCD users were reported as trichomanias 0.8% and candida species 12.07% respectively. We observed that most of the cases initially thought to be LSIL were later attributed to reactive changes specific to IUCD use. Prevalence of LSIL 5.26% and HSIL 0.87% have been reported. Conclusion: These cytopathological changes don’t occur in all the IUCD users and most of changes that do occur are benign and do not require treatment. However, women who use IUCDs should undergo regular cervical cancer screening to detect any abnormal changes that may require further investigation or treatment.

Immediate postpartum intrauterine contraceptive device use among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, Ethiopia: Intentions and barriers.

This study aimed to assess the intention and barriers to the use of immediate postpartum intrauterine contraceptive devices among pregnant women attending antenatal clinics in Jimma town public healthcare facilities, southwest Ethiopia. A facility-based cross-sectional study design was conducted from 1 September to 30 October 2020 by using a systematic sampling technique. Data were entered into Epi-data 3.1 version and exported to Statistical Package for Social Sciences 23 for analysis. A binary logistic regression analysis was done to sort candidate variables for multiple logistic regression, and multivariable logistic regressions were done to identify factors associated with the intention to postpartum intrauterine contraceptive devices. Factors associated with intention to use immediate postpartum intrauterine contraceptive device declared at 95% confidence interval. This study finding showed that 37.6% (95% confidence interval (31.5, 43.7)) of pregnant women intended to use the immediate postpartum intrauterine contraceptive device after their delivery. The main reason women refused to use immediate postpartum intrauterine contraceptive devices was being satisfied with other methods to use after they gave birth (27.5 %), the concern of health harm (22.2%), and the fear of impaired future fertility (16.4%). The identified factors that were statically significant with the intention to use immediate postpartum intrauterine contraceptive devices among pregnant women were included: attended secondary education (adjusted odd ratio = 2.36; p = 0.03; 95% confidence interval (1.089, 5.128)), attended college and above (adjusted odd ratio = 2.99; p = 0.020; 95% confidence interval (1.189, 7.541)), have high knowledge on immediate postpartum intrauterine contraceptive devices ((adjusted odd ratio = 2.10; p = 0.006; 95% confidence interval (1.236, 3.564)), the previous history of LACM used (adjusted odd ratio = 6.85; p = 0.0001; 95% confidence interval (3.560, 10.021)), parity >4 (adjusted odd ratio = 1.86; p = 0.043; 95% confidence interval (3.99, 8.703)). The intention of pregnant women to use after they gave birth in the study area was low. Maternal educational level, high knowledge, history of previous long-acting contraceptive methods use, and parity were significantly associated with pregnant women's intention to use immediate postpartum intrauterine contraceptive devices. Healthcare providers should focus on delivering crucial information about immediate postpartum intrauterine contraceptive device benefits for postpartum women, particularly concerning reducing barriers during antenatal care follow-up as they plan to use it after their delivery.

Faktor-Faktor Yang Mempengaruhi Rendahnya Pemakaian KB Alat Kontrasepsi Dalam Rahim (AKDR) Di Puskesmas Talang Rimbo Lama Kabupaten Rejang Lebong Tahun 2022

Based on data obtained from the Rejang Lebong District Health Office in 2021, the number of AKDR family planning acceptors such as IUDs was 32. This number is still very low when compared to hormonal family planning such as implants with 482 acceptors, injections with 16,004 acceptors, and pills with 7,720 acceptors. Meanwhile, the national target for active family planning participation in 2020 is 20.5%. Puskesmas Talang Rimbo Lama, Rejang Lebong Regency, is one of the health centres with low MDR participants in the last 3 years, namely in 2019 there were 6 acceptors, in 2020 there were 5 acceptors, and in 2021 there were 4 acceptors. Objective To know the factors that influence the low use of domestic contraceptives (IUD) at the Talang Rimbo Lama Health Centre, Rejang Lebong Regency, in 2022. descriptive quantitative research with analytical survey research methods using cross-sectional design. The sample in the study was 68 people using the accidental sampling technique. The research instrument used was a questionnaire sheet. The research analysis used univariate and bivariate analysis with the chi-square test. The results showed there was no relationship between parity (p = 0.648) and the low use of intrauterine contraceptives (IUD) at the Talang Rimbo Health Centre, Rejang Lebong Regency, in 2022. There is a relationship between knowledge (p 0.044) and husband support (p = 0.033) and the low use of intrauterine contraceptives (IUD) at the Talang Rimbo Health Centre, Rejang Lebong Regency, in 2022. Suggestions: It is necessary to explore the knowledge of respondents related to the incidence of diabetes mellitus so that field interventions to improve respondents' knowledge are more appropriate. It is necessary to conduct socialisation for PUS related to IUDs so that people understand the advantages and disadvantages of IUDs.

Factors Related to the Low Use of Intraceptive Devices (IUD) in Women Couple of Reproductive Age at Public Health Center Tiga Balata, Simalungun Regency

The Family Planning Program (KB) is a national program that improves the health status and welfare of women, children and families in particular, and the nation in general. The use of the IUD method in Indonesia is able to significantly reduce the Total Fertiliry Rate (TFR). The IUD is an effective contraceptive device but can cause interference with the reproductive organs due to its presence in the uterus where the IUD is a foreign body for the uterus so that it causes many side effects for the acceptor, for example resulting in increased volume and length of menstruation (metroragia) caused by mechanical factors in the uterus. endometriosis due to a mismatch between the size of the IUD and the uterine cavity and possibly due to intra-uterine or ectopic pregnancies. The purpose of this study was to determine the factors associated with low use of intrauterine contraceptive devices (IUD) in women of childbearing age couples at Tiga Balata Health Center. The results of the study based on the results of the Chi-Sguare statistical test showed that there was a relationship between age and IUD use p value = 0.001 ≤ α (0.05), there was a relationship between education and IUD use p value = 0.006 ≤ α (0.05,) there was a relationship between knowledge and IUD use p value = 0.019≤ α (0.05), there is a relationship between the number of children and IUD use p value=0.004 ≤α(0.05), there is a relationship between the availability of equipment and IUD use p value=0.000 ≤ α (0.05 ), there is a relationship between the support of health workers and IUD use p value = 0.001≤ α (0.05), there is a relationship between family support and IUD use p value = 0.008 ≤ α (0.05).