Intrauterine Contraceptive Device Users Research Articles

Ovarian Tube Abscess in an Intrauterine Contraceptive Device User for 5 Years: A Case Report

A tubo-ovarian abscess (TOA) is one of the late complications of untreated Pelvic Inflammatory Disease (PID) and can be life-threatening if the abscess ruptures and results in sepsis.1 It most commonly affects women of reproductive age and nearly 60% of women with TOA are nulliparous.2 The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper genital tract infection is highest during the immediate period following the insertion of an IUD. We report a case of pelvic inflammatory disease in a 44-year-old woman using an intrauterine contraceptive device (IUD) for more than 5 years, who complained of lower abdominal pain and lumbar pain without fever, and also had a thick-white vaginal discharge. The clinical diagnosis was performed by anamnesis and ultrasound (we found an hypo- hyperechoic mass on the right adnexa size 4.4 x 3.6 x 4.0 cm) and then the patient was treated with triple antibiotics for 3 days. Afterward, the patient was performed using exploring laparoscopy to continue to right salpingo-oophorectomy adhesiolysis left tubectomy, and IUD removal as well. Long-term users of IUDs remain at risk for serious pelvic infections. Every IUD user's patient should be routinely counseled by their gynecologist and tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, abdominal pain, and lumbar pain. The treatment must be a combination of antibiotics and surgery.

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.

Issues Related to IUCD Discontinuation Rates among IUCD Users in Kembata Tembaro Zone, Southern Ethiopia

Background: Intrauterine contraceptive devices (IUCDs) are made of T-shaped plastic and are inserted into women’s uteruses to prevent unwanted pregnancies. Despite the improvement in the availability and utilization of intrauterine contraceptive devices, discontinuation is becoming a public health concern. A significant proportion of women discontinue the method before its due date, which poses a concern in the health system, and its consequences may lead to the failure of a programme. As a result, the purpose of this study was to investigate the issues related to IUCD discontinuation rates among IUCD users IN twelve months ago in Kembata Tembaro Zone, Southern Ethiopia, in 2022. Methods: A community-based, cross-sectional study was conducted. 415 women who had inserted an IUD from July 2021 to June 2022 in the Kembata Tembaro Zone were selected using a multistage sampling technique included in the analysis. This study's data collection instruments were pre-tested structured questionnaires. The coded data was entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Finally, binary logistic regression analysis was carried out to identify independently associated factors and odds ratios at a 95% confidence interval with a significance level of p-value less than 0.05. Results: Analysis revealed that 21% (95% CI 16.5-22.8) of women discontinued the use of their intrauterine contraceptive device in the last year. Issues like not being counselled about the intrauterine contraceptive device before insertion [AOR = 3.7; 95% CI: 1.23–7.30], not being appointed for follow-up [AOR = 2.8; 95% CI: 1.12–6.70], being married [AOR = 2.9; 95% CI: 1.35–6.23], and needing to have more children [AOR = 3.2; 95% CI: 1.5–7.0]. Conclusions: The findings of this study conclude that the overall magnitude of the IUCD discontinuation rates in the study area were found to be high when compared with different studies conducted in Ethiopia. Many of the factors that are attributed to the high magnitude of IUCD discontinuation are changeable. Appropriate counseling prior to insertion, including an appointment for follow-up visits, the preference to have more children, and marital status for the choice of service, will improve the continuation rate of IUCD.

A retrospective study on efficacy and safety of copper T 380 A as a contraceptive method

: The copper T intrauterine contraceptive device (IUCD) is a widely used reversible contraceptive method all over the world today. They are effective and recommended for use up to 10 years. Intrauterine contraceptive device used as a spacing method in many couples. Some of the causes for removal include desire for pregnancy and sterilization etc. : To determine the efficacy of copper T(Cu T) 380 A as a contraceptive method. To determine the indications of discontinuation of Cu T 380 A. To identify the difficulties faced during removal in outpatient basis and cases which required removal under anaesthesia in operation theatre.: Retrospective analysis of Cu T removals done at Gandhi hospital, Secunderabad over 6 months duration, from December 2021 to May 2022. A total number of 128 cases were observed and included in this study.: Among the IUCD users, majority belonged to age group of 20 – 30 years. Most of the cases reported for removal came after 2-5 years of usage. Among them, most were referred from periphery in view of difficulty in removal, as Gandhi hospital is a tertiary care centre. Out of 128 cases of total Cu T removals, 68 cases(53.1%) were removed on outpatient basis, 60 cases (46.8%) were removed under anaesthesia. Major indication for removal was desire for pregnancy in 99 cases (77.3%), 26 (20.3%)cases were removed for sterilization, 1 (0.78%) case was removed for failure of contraception, 1 (0.78%)case for abnormal uterine bleeding and dysmenorrhea, 1 (0.78%) case for uterine perforation.: Copper T is an effective, safe, long-lasting, convenient reversible contraceptive method with very few side effects. The information in this study may be useful to counsel women who are considering the IUCD as a contraceptive method and current users who are requesting for removal due to side effects.

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.

FAKTOR -FAKTOR YANG MEMPENGARUHI PEMILIHAN ALAT KONTRASEPSI PADA AKSEPTOR KELUARGA BERENCANA

The strategy to reduce fertility rates is through contraception to prevent pregnancy, but not all contraceptives are suitable for the physical health condition of the wearer. Active family planning participants in Metro City in 2020 amounted to 21917 (72.73%). The coverage of intrauterine contraceptive users in Metro City is 3439 (15.%), and the lowest is in the Karangrejo Health Center working area, which is 10.61% (106 out of 999 acceptors). This study aimed to determine the factors that influence the selection of contraceptives in family planning in Karangrejo Village. Methods: Quantitative research with a cross-sectional design, the population of family planning acceptors is 1374 family planning acceptors. With the results of the calculation of the sample size obtained, a sample of 94 respondents—was sampled with a simple random sampling technique. The data was collected using a questionnaire, and the analysis used univariate, bivariate, and multivariate multiple regression analysis. Results: The results of the bivariate test conducted on nine variables related to the use of IUD contraception only five variables, namely knowledge (p=0.03), occupation (p=0.002), economy (p=0.041), husband's support (p= 0.000) and health status during family planning (p= 0.000) while the other four variables were not related because the p-value was more than 0.05, namely education (p=0.210), number of children (p=0.670), history of the hereditary disease (p= 1,000) and confidence (p=1,000). In the multivariate analysis of variables, because the husband's support and maternal health status during family planning were constant, they were not included in the modeling. The final result of modeling obtained knowledge (p=0.07, 95% CI: 0.35 - 0.597) and occupation (p=0.12, 95% CI: 1.493 - 25,631). Conclusion: Results The most dominant factor is the husband's support factor, followed by maternal health during family planning, knowledge of contraceptives, and mothers who do not work / homemakers. Suggestion: In promoting the family planning program, the first step is to approach and educate the husbands of prospective acceptors. It is necessary to increase knowledge about family planning contraceptives, especially for wives who do not work or are homemakers.

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)...

Demographic features of users and uptake of intrauterine contraceptive device (IUCD) and reasons for removal at University of Calabar Teaching Hospital, Nigeria: A 5-year review

Background: Intrauterine contraceptive device (IUCD) is an effective long-acting reversible contraceptive method that is suitable for women of reproductive age. Despite this, its uptake by women in Nigeria is not optimum. Objectives: The objectives were to determine the uptake, demographic characteristics of users, and reasons for the removal of IUCD use at the University of Calabar Teaching Hospital (UCTH), Nigeria. Materials and Methods: This was a retrospective study of family planning clients, who accepted and inserted IUCD at UCTH, Calabar, between January 1, 2013, and December 31, 2017. Case records of clients were retrieved and reviewed. Data extracted were entered into excel and analyzed using SPSS. Results: Out of 10,102 clients during the period, 1,032 clients accepted and inserted IUCD, giving an uptake rate of 10.2%. There was a gradual decline in the uptake of IUCD from 383 (37.1%) in 2013 to 96 (9.3%) in 2017. The sociodemographic features of IUCD users showed a mean age of 33.53 ± 5.94 with the majority, 696 (67.4%) having tertiary education. The majority were para 3 or 4 and accounted for 627 (60.7%), whereas 662 (64.2%) had previously used a modern contraceptive method. Sixty-five (6.3%) clients had their IUCD removed. The commonest reason for the removal was desire to get pregnant, 44 (67.7%), and side effects of IUCD (20.6%). Conclusion: There was a low uptake of IUCD, with a decline in the trend over the study period. Side effects affected the removal of the the IUCD. There is a need for awareness creation and education of women, appropriate counseling, and good patient selection in order to increase uptake.

Is Copper Intra Uterine Contraceptive Device-Induced Menorrhagia Correlated with Changes in Transvaginal Ultrasound Findings before and after Insertion?

Background: Many women all around the world use the Cu T 380A for contraception as it is cheap and effective way for contraception. Menorrhagia is the most common cause of removal of the intra uterine contraceptive device (IUCD) and it is a very annoying side effect for IUCD users. Finding a way to avoid such a complaint is important to find a proper way for contraception. Objective: To prove the correlation between the Cu IUCD-induced menorrhagia and the findings of the transvaginal Doppler ultrasound. Patients and Method: It was a prospective cross-sectional study and it was conducted on eighty four women who were referred to the family planning clinic of Zagazig University Hospital and Zagazig General Hospital for Cu T-380A IUCD insertion. The study was conducted in the period from 1/1/2019 to 30/7/2019. Then, all specimen had been classified into 2 groups:Group 1 (n =37): with menorrhagia, and group 2 (n = 47) without menorrhagia. Results: Uterine artery pulsatility index (PI) and resistance index (RI) after one month of insertion were significantly lower than at time of insertion among women with IUCD-induced menorrhagia. Endometrial thickness after one month of insertion was significantly higher than at time of insertion among women with IUCD-induced menorrhagia. PI and RI at time of insertion were significantly lower in women with IUD-induced menorrhagia than in those using IUD with normal menstrual bleeding. Uterine artery PI ≤ 1.99 and RI ≤ 0.82 have been associated with menorrhagia at time of insertion. Conclusions: The transvaginal Doppler ultrasound is very helpful in prediction of menorrhagia among IUCD users.

INTERNAL VAGINAL DOUCHING INCREASES THE RATE OF VAGINAL INFECTION IN INTRAUTERINE CONTRACEPTIVE DEVICE USERS: A CROSS SECTIONAL STUDY

To compare the frequency, type, and severity of vulvovaginitis in women who are performing vaginal douching (VD) or not while using an intrauterine contraceptive device (IUCD). This study was a cross-sectional study conducted on 604 consecutive IUCD users presented to an outpatient clinic in a tertiary hospital in Egypt. They should have been using the cupper IUCD for at least 6 months before recruitment. Women were stratified into two groups according to if they were performing internal VD or not. Group I (302 women) performing internal VD and Group II(302 women)not practicing this habit (NVD). The primary outcome of the study was to compare the frequency of vaginal infections in IUCD users who perform VD compared to women who were abstaining from this habit. Secondary outcomes included the type and severity of infection in both groups. Women who were using IUCD and performing internal VD had a past history of more frequent episodes of vaginal infection compared with NVD IUCD users {260 (88.1%) versus 151(43.4%); respectively} (P<0.001). Current vaginal infection was significantly higher in VD (275; 91.05%) compared to NVD (115; 38.1%) (P<0.001). Bacterial vaginosis was the most common clinical detected type of infection (287; 47.5%) followed by candida vulvovaginitis (278; 46.03%). Moreover, both types of infection were significantly more common in VD versus NVD groups (p<0.001). Internal VD while using IUCD is associated with a higher risk of vulvovaginal infections. In these women bacterial vaginosis is more common than candida vulvovaginitis.

Evaluation the Role Uterine Artery Doppler Indices in Prediction of Abnormal Uterine Bleeding In Intrauterine Contraceptive Device Users

Contraceptive intrauterine device (IUD) is a successful method of contraception which has been used for more than 30 years. The objectives of our study were to evaluate the correlation between abnormal uterine bleeding in IUD users and uterine artery Doppler [pulsitility index (PI); Resistant index (RI)] using transvaginal ultrasound and Doppler. The study included 120 women from obstetrics and gynecology department Hospital. ,divided into three groups: Group I included forty female using coipper intrauterine device withbleeding Group II included forty female using CIUD without bleeding. Group III included forty ladies as a control group. All fullfil the inclusion and exclusion criteria History was obtained. Examination was done: Routine investigations: The Results Of This Work Were:- As regard to Doppler findings, it was noted that RI was significantly lower in group I in comparison to group II and group III and Pulsitility index (PI) followed the same pattern as RI. We can conclude that detection of PI and RI in the uterine artery could be used to identify patients at risk of developing excessive bleeding after copper IUD insertion.

Evaluation of Predictive Value of Uterine Artery Doppler Indices versus Histopathology Sampling in Detection of Abnormal Uterine Bleeding in Intrauterine Contraceptive Device Users

Background: Contraceptive intrauterine device (IUD) is a successful method of contraception that has been used for more than 30 years. However, it is associated with excessive uterine bleeding, that might cause iron deficiency anaemia, making CIUD use inconvenient for many women especially those with severe menstruation. Objective: The objective of our study was to evaluate the correlation between abnormal uterine bleeding in IUD with endometrial sampling. Methods: Study included 120 women from the obstetrics and gynaecology departments of Zagazig University Hospitals, divided into three groups: Group I included 40 women who used intrauterine coipper (TCu-380A) and complained of menorrhagia or menometrorrhagia. Group II included 40 womenusing CIUD and not complaining of abnormal uterine bleeding. Group III included 40 women complaining of vaginal discharge or requesting CIUD insertion, and not complaining of abnormal uterine bleeding as a control group. Results: PI and RI were significantly lower in IUD-induced irregular bleeding than in IUD-induced women who did not complain of abnormal vaginal bleeding. Conclusion: Endometrial biopsy has no role in predicting the abnormal uterine bleeding cause. Transvaginal ultrasonography findings can be efficiently used to classify women at risk of experiencing excessive uterine bleeding following CIUD insertion and to make a preliminary diagnosis, thus, notify the pathologists.

The impact of method choice on the risk of contraceptive discontinuation: Egypt 2014

Purpose In Egypt, the IUD is the most common contraceptive method since 1988 and has remained so despite a recent drop in its share from 59.9% in 2008 to 51.5% in 2014 in favour of hormonal methods, which increased from 19.7% for pills and 12.3% for injectables in 2008 to 27.4% and 14.5% in 2014 according to 2014 Egypt demographic and health survey (EDHS). The recent shift away from intrauterine contraceptive device (IUDs) to hormonal methods have contributed to increased discontinuation. This paper aims to answer three questions: To what extent does the method type influence the hazard of contraceptive discontinuation in Egypt? Is the interaction between method type and duration of use a predictor of the probability of discontinuation after controlling other variables? What are the other important background variables that affect the hazard of contraceptive discontinuation? Design/methodology/approach Using data from EDHS2014, separate multilevel discrete-time proportional hazard models for events of interest (abandoned use while in need, switched to another method in the month following discontinuation and method failure) were built. Findings Only IUD users are significantly less likely to abandon use while in need and to experience method failure and a reduced risk of switching. During the first 6–10 months of use, all types of discontinuation can be significantly reduced for all three methods. Demographic variables do not significantly affect abandonment but strongly affect switching and significantly affect failure. Socio-economic variables do not significantly affect abandonment and switching. Exposure to media has a significant effect on abandonment but not on switching. Community contraceptive prevalence rate strongly affects switching. Originality/value Results confirm that the counselling should be more intense during the first year of method use and should pay special attention to women who are 25 years old and above and those who have two or more children. Also, media campaigns are important and especially those addressing the issue of abandoning while in need.

Association between contraceptive method chosen after induced abortion and incidence of repeat abortion in Northern Portugal

Objectives In Portugal, a country with strong Catholic roots, elective termination of pregnancy at women’s request is still stigmatised, especially if it is a repeat abortion. The objectives of this study were to determine the incidence of repeat abortion, taking into account the contraceptive method chosen after the index abortion event, and characterise the risk factors for repeat abortion. Methods This was a retrospective cohort study of 988 women who requested termination of pregnancy during 2015 in a Portuguese tertiary care public hospital. Contraception was given free of charge after the index event. The occurrence of a repeat induced abortion was evaluated during a 24 month follow-up period. Results Forty-nine (5.0%) of the 988 women had a repeat abortion. Users of long-acting reversible contraception (LARC) had fewer repeat abortions compared with users of non-LARC methods. Overall repeat abortion was 0.8% in subcutaneous contraceptive implant users, 1.5% in intrauterine contraceptive device (IUCD) users, 2.8% in vaginal ring users and 5.8% in oral contraceptives users (p < 0.05). Cox hazards ratio (HR) analysis showed that method choice after abortion correlated significantly with the probability of repeat abortion (p < 0.05). Using women choosing oral contraception as the reference group, the HRs (95% CIs) for repeat abortion were as follows: IUCD 0.282 (0.084, 0.942), contraceptive implant 0.142 (0.019, 1.050), vaginal ring 0.508 (0.175, 1.477). Conclusion Even though highly effective contraceptive methods are freely accessible in Portugal, other challenges must be managed to improve outcomes, such as a timely, patient-centred counselling approach.

Factors associated with intrauterine contraceptive device use among women of reproductive age group in Addis Ababa, Ethiopia: A case control study.

Intrauterine Contraceptive Device (IUCD) is a highly effective and reversible modern contraceptive, which is still significantly underutilized in Ethiopia. The aim of this study was to identify factors affecting the use of IUCDs among women of reproductive age group in Addis Ababa. Facility-based, unmatched case-control study was employed among randomly selected cases and controls in selected health centers in Addis Ababa from August to October 2017. The cases (n = 128) were women of reproductive age group who were IUCD users and controls (n = 256) were women of reproductive age group who were users of oral or injectable contraceptives during the study period. After randomly selecting two health center from each sub-city the number of cases and controls were equally allocated to each of the selected health centers. In each selected health center, all eligible cases were enrolled consecutively until the sample size was achieved. Two consecutive controls were selected for each case. Data was collected face-to-face by trained nurses by using structured questionnaire. Factors associated with IUCD use were identified by multi-variable binary logistic regression models using the backward conditional stepwise method. In the multi-variable analysis, IUCD use was strongly associated with husbands/partners being supportive of IUCD use (Adjusted OR = 13.24, 95% CI; 5.30-33.02), being literate women (Adjusted OR = 5.31, 95% CI; 1.05-26.93), women having a perception of IUCD does not cause infection (Adjusted OR = 4.38, 95% CI; 1.45-13.26) and the source of information about IUCD being mass-media (Adjusted OR = 3.81, 95% CI; 1.49-9.74). The findings of the study reinforce the need of husbands/partners involvement in the interventions to enhance utilization of IUCD. Moreover, due attention should also be provided for delivering IUCD-related messages in the public mass-media.

Bacterial vaginosis, vulvovaginal candidiasis and trichomonal vaginitis among reproductive-aged women seeking primary healthcare in Sana\u2019a city, Yemen

BackgroundIn Yemen, the underlying causes of infectious vaginitis have been neglected. Therefore, this study aimed to determine the prevalence and risk factors associated with bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomonal vaginitis (TV) among non-pregnant reproductive-aged women.MethodsA cross-sectional study was conducted among 347 non-pregnant reproductive-aged women seeking primary healthcare in Sana’a city, Yemen. Data about sociodemographic characteristics, lifestyle-related behaviors, routine hygienic practices, menstrual care and history and type of contraceptive intake were collected using a structured questionnaire. Vaginal discharge samples were collected and examined for discharge characteristics and pH by a gynecologist. Then, samples were examined for BV, VVC and TV. Data were analyzed using suitable statistical tests.ResultsVaginal infections were prevalent among 37.6% of reproductive-aged women, where BV was the most prevalent (27.2%). VVC was significantly higher among symptomatic women and significantly associated with itching (P = 0.005). Using bivariate analysis, the age of < 25 years (odds ratio [OR] = 1.9, 95% confidence interval [CI]: 1.16–3.10; P = 0.010) and using intrauterine contraceptive devices (IUCDs) (OR = 1.8, 95% CI: 1.09–2.89; P = 0.020) were significantly associated with BV, while history of miscarriage was significantly associated with a lower risk of BV (OR = 0.5, 95% CI: 0.31–0.85, P = 0.009). However, polygyny was significantly associated with VVC (OR = 3.4, 95% CI: 1.33–8.66; P = 0.007). Multivariable analysis confirmed that age of < 25 years and using IUCD were the independent predictors of BV, while history of miscarriage was an independent protective factor against BV. On the other hand, marriage to a polygamous husband was the independent predictor of VVC.ConclusionsMore than a third of non-pregnant reproductive-aged women seeking PHC in Sana’a have single or mixed infections with BV, VVC or TV. BV is the most frequent cause of vaginitis and is significantly associated with the age of < 25 years and using IUCDs, while VVC is significantly higher among women with polygamous husbands. Health education of polygamous husbands and their wives, regular monitoring of BV among IUCD users and screening women for vaginitis before treatment are recommended.

Unilateral intact twin tubal pregnancy in an intrauterine contraceptive device user: a case report

Unilateral intact twin tubal pregnancy in an intrauterine contraceptive device user: a case report

Improving information on intrauterine contraception: providing advice in primary care.

More women choosing to use very effective contraceptive methods like intrauterine contraception (IUC) can lead to higher standards of sexual and reproductive health and wellbeing. Fear may inhibit some women in the UK from using IUC. Although information that can potentially address this problem is available,1,2 in practice inaccurate information and consequently inadequate care are sometimes still offered to women. More accurate information and positive experiences could lead to more women choosing to use IUC and recommending it to others. This article offers suggestions for changes and improvements to some aspects of IUC information and care based on the available evidence. IUC is very effective, long acting, and the commonest reversible method of contraception used in the world. It is provided by the insertion of a flexible plastic device impregnated with either copper or a hormone into the woman’s uterus. Copper IUC acts immediately, is the most effective form of emergency (postcoital) contraception, and is associated with a reduced risk of cervical cancer. Hormonal IUC users tend to experience less menstrual bleeding and amenorrhoea. Intrauterine devices (IUDs) impregnated with up to 52 mg of levonorgestrel (for example, Mirena® [levonorgestrel, Bayer Plc]) are recommended for heavy menstrual bleeding, as the progestogen component of hormone replacement therapy, and reduce the risk of endometrial cancer.2 IUC has the highest satisfaction and continuation rates of all long-acting reversible contraceptives irrespective of age, race, parity, education, socioeconomic status, and history of sexually transmitted infection.3 This is similar for contraception use post-termination of pregnancy (TOP): compared with combined oral contraceptive users, copper …

Study of cervical papanicolaou smear in intrauterine contraceptive device users in a tertiary care hospital

Background: The use of intrauterine contraceptive device (IUCD) generally has been known to be safe and effective but tends to have some side effects. Reproductive tract infection is one of the major complications caused by prolonged usage of an IUCD. Cervical smears have shown an increase in inflammation, inflammatory epithelial changes, or metaplastic cells among the IUCD users as compared to nonusers. There is also a predisposition to higher rate of infections such as Actinomyces, atypical squamous cells of undetermined significance, and low-grade squamous intraepithelial lesion. Aims and Objectives: The aim of this study was to study changes in cervical cytology in IUCD users and to assess the risk of epithelial cell abnormalities among IUCD users compared to nonusers. Materials and Methods: A 2-year cross-sectional study was carried out to screen Papanicolaou (Pap) smears in women of the reproductive age group who were categorized as IUCD and non-IUCD users. Results and Observations: A total of 1100 (550 + 550) Pap smears from IUCD and non-IUCD users were analyzed. Among IUCD users, 544 cases (98.90%) were adequate for reporting including 533 cases (97.98%) showing negative for intraepithelial lesion or malignancy (NILM) and 11 cases (2.02%) showing epithelial cell abnormality (ECA). In non-IUCD users, 541 cases (98.36%) were adequate for reporting. Among these, 538 cases (99.44%) showed NILM and 3 cases (0.56%) showed ECA. Conclusion: In IUCD users, the prevalence of infections and ECA is higher than non-IUCD users.