Intrauterine Device Use Research Articles

Abstract 2217: Associations between intrauterine device use and ovarian cancer risk among 11 population-based case-control studies

Abstract Background: Intrauterine device (IUD) use has increased while oral contraceptive (OC) use has decreased among premenopausal women. It is unknown whether IUDs offer protection against epithelial ovarian cancer (EOC), similar to OCs, or may increase risk. Therefore, we examined the association between IUD use and EOC risk. Methods: Information on contraception use was obtained through questionnaires from 11 studies participating in the Ovarian Cancer Association Consortium and African-American Cancer Epidemiology Study. Study-specific odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional multivariable logistic regression, and heterogeneity between studies was assessed using Cochran Q and I2 statistics. There was no evidence of heterogeneity, thus data were pooled. We assessed potential effect modification by decade of birth, race, parity, and personal history of endometriosis by reporting stratum-specific estimates and tested for multiplicative interaction by comparing models with and without interaction terms via likelihood ratio test. Polytomous logistic regression was used to estimate histotype-specific associations. Results: Results were pooled for 11,033 EOC cases and 13,358 controls. There were 2,656 (19.9%) IUD users (mostly non-hormonal) and 8,923 (66.8%) OC users among controls compared to 1,933 (17.5%) IUD users and 6,318 (57.3%) OC users among cases. IUD use was associated with lower risk of endometrioid (OR: 0.73, 95% CI: 0.62-0.86) and clear cell (OR: 0.63, 95% CI: 0.48-0.80), but not high-grade serous subtypes (OR: 1.05, 95% CI: 0.98-1.14), with significant heterogeneity by histotype (p=0.0006). Among studies that collected data on IUD type, we observed a non-significant inverse association between hormonal IUD use and EOC (OR: 0.72, 95% CI: 0.51-1.03); however, only 51 cases reported hormonal IUD use. Among those who used both IUD and OCs, there was no association with the order of contraception use and EOC. There were no major differences in the associations of age at first use, duration of use, or time since last use and EOC risk. Among parous women, IUD use before first pregnancy was associated with a non-significant reduced odds of EOC (OR: 0.82, 95% CI: 0.65-1.04). We also observed a statistically significant interaction between IUD use and endometriosis with reduced odds of EOC associated with IUD use among women with endometriosis (OR: 0.77, 95% CI: 0.60-0.98) but not those without endometriosis (OR: 0.96, 95% CI: 0.90-1.03, p-interaction=0.05). Discussion: IUD use was associated with lower clear cell and endometrioid EOC risk and may be most protective among women with endometriosis. Future research should include cohorts of women with a higher prevalence of hormonal IUD use to determine the impact of changing contraceptive trends on ovarian cancer burden and identifying preventive strategies for women at high risk. Citation Format: Jennifer M. Mongiovi, Ana Babic, Naoko Sasamoto, Lauren Peres, Holly Harris, Mollie E. Barnard, Shelley S. Tworoger, Anita Koushik, Joellen M. Schildkraut, Jennifer A. Doherty, Kathryn L. Terry, the Ovarian Cancer Association Consortium & the African-American Cancer Epidemiology Study. Associations between intrauterine device use and ovarian cancer risk among 11 population-based case-control studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2217.

Abstract 2195: Intrauterine device use and risk of invasive epithelial ovarian cancer: A population-based case-control study

Abstract Introduction: Ovarian, fallopian tube, and primary peritoneal cancers (hereafter referred to as ovarian cancer) are the most fatal gynecologic cancers. Thus, it is imperative to identify strategies that can reduce the risk of the disease. Several contraceptive methods have been shown to be associated with a reduced risk of ovarian cancer, including combined oral contraceptives, injectable progestins, and tubal ligation. However, the use of these contraceptive methods has been decreasing in the U.S., with a growing preference for intrauterine devices (IUDs) for pregnancy prevention. Previous case-control studies on the association between IUD use and ovarian cancer risk have found inconsistent results. Notably, previous studies had small sample sizes and did not restrict to invasive epithelial tumors. The current analysis assessed the association between IUD use and risk of invasive epithelial ovarian cancer in a large population-based case-control study. Methods: This analysis used data from 1,713 people diagnosed with primary invasive epithelial ovarian cancer (cases) and 2,348 cancer-free people (controls) participating in a case-control study conducted in Los Angeles, CA from 1992-2010. The study consisted of four waves of recruitment with similar enrollment and data collection methods. Logistic regression models were fit to assess the association between IUD use and risk of invasive epithelial ovarian cancer. All models were adjusted for age, race/ethnicity, education, first-degree family history of ovarian cancer, endometriosis, body mass index, duration of combined oral contraceptive use, parity, duration of breastfeeding, tubal ligation, and study wave. Heterogeneity across the study waves and the ovarian cancer histotypes was evaluated using standard meta-analysis techniques. Results: There was no statistically significant association between IUD use and risk of invasive epithelial ovarian cancer (odds ratio=1.09, 95% confidence interval 0.93-1.28). This result was consistent across the study waves and the ovarian cancer histotypes (p-values for heterogeneity>0.05). Conclusion: IUD use was not associated with the risk of invasive epithelial ovarian cancer. Analysis by IUD type (i.e., hormone-releasing vs copper IUDs) was not possible in this study as these data were not collected. Future research should examine whether the type of IUD (i.e. copper versus hormone-releasing) may have different effects on risk of ovarian cancer. Citation Format: Minh Tung Phung, Yuting Wang, Alice W. Lee, Malcolm C. Pike, Anna H. Wu, Celeste Leigh Pearce. Intrauterine device use and risk of invasive epithelial ovarian cancer: A population-based case-control study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2195.

Effects of intrauterine device use on attack frequency and severity ın woman of reproductive age with familial Mediterranean fever.

Familial Mediterranean fever (FMF) is the most common inherited autoinflammatory disease in the world. There are known triggers to initiate an FMF attack, yet potential effects of intrauterine devices (IUD) in women of reproductive age have not been evaluated before. Consecutive female patients with FMF who ever used IUD over the age of 18 were enrolled. Female patients with FMF were sub grouped according to the type of IUD they use. FMF attack frequency, severity, duration, presence of dysmenorrhea, severity of dysmenorrhea, having attacks during menstruation before and after IUD use were questioned. Demographic and clinical data were collected from hospital database. When all patients with IUD use were evaluated, it was found that the frequency of attacks increased after IUD insertion at 3rd and 12th months (median [min-max] attack frequency at 3rd month, 1 (0-3) vs 1 (0-6), p = 0.002, median [min-max] attack frequency at 12th month, 2 (0-12) vs 3.5 (0-18), p = 0.028). Attack severity measured by VAS pain was also significantly increased. Attack duration and menstrual pain was similar before and after IUD use. Attack frequency at 3rd and 12th months, attack severity and menstrual pain was all increased significantly in Cu-IUD users, whereas none of these parameters deteriorated in LNG-IUD group. IUD use, especially Cu-IUD, may increase the frequency and severity of attacks in female patients with FMF. Clinicians may benefit from considering LGN-IUD if IUDs are preferred as contraception in women of childbearing age with FMF.

Differing Approaches to Pain Management for Intrauterine Device Insertion and Maintenance: A Scoping Review.

Intrauterine devices (IUDs) are considered a reliable contraceptive option for women,but they can come with side effects. There is a disconnect in standard guidelines for IUD insertion within and without the U.S. The objective of this review was to address a gap in the literature regarding official procedures for pain management during IUD implantation.This scoping review was initiated using keywords to extract relevant articles from multiple databases: U.S. National Library of Medicine National Institutes of Health (PubMed), MEDLINE (Ovid), and Excerpta Medica dataBASE (EMBASE, Ovid). Initially, 457 articles were identified and after a rigorous screening and selection process, 37 articles were chosen to be further assessed to ascertain if they met the study's inclusion criteria. Those 37 articles were further evaluated fully to check for relevancy. From that process, 19 articles were chosen for the review, and all passed quality assessment evaluations using the JB Appraisal Tools. To best address the research question, the data from the 19 articles were divided into three categories: 1) circumstantial factors, 2) non-pharmacological methods, and 3) pharmacological methods. Circumstantially, women with previous vaginal deliveries experienced the lowest pain during the procedure, and nulligravid (never pregnant) women experienced the most pain. Lower pain scores were reported by lactating women compared to non-lactating. Black women experienced the most anticipated pain compared to other races. Regarding non-pharmacological methods, different insertion techniques, tools, and the use of a cold compress were found to not affect the level of pain during IUD insertion. Lastly, it was shown that pharmacological methods such as lidocaine gel, lidocaine paracervical block, and lidocaine combined with either diclofenac or prilocaine decreased pain scores at different time stamps of the procedure. Also, oral ketorolac and a vaginal combination of misoprostol and dinoprostone helped reduce pain.Findings from this scoping review revealed a lack of uniformity across practices when performing IUD insertions, possibly due to differences in procedures across circumstantial factors, non-pharmacological methods, and pharmacological methods. More research is needed to investigate the intricacies of pain with IUD insertion. Moving forward, especially following a potential increase in the use of IUDs after the reversal of Roe v. Wade, establishing this gap may lead to a more refined standardized protocol to mitigate pain with IUD insertions.

Factors Influencing Breast Cancer Awareness in Rural Southwest China: A Cross-Sectional Study.

This study aimed to explore the current knowledge level of breast cancer among rural women in Southwest China and analyze the influencing factors of breast cancer cognition. From May to November 2022, 1468 rural women were invited to participate in this study. Demographic information and the Chinese version of the Breast Cancer Awareness Measure (C-BCAM) were collected through one-on-one investigations. The data were analyzed using descriptive statistics, chi-square tests, and multiple regression analysis in SPSS 26.0. The study included a total of 1468 rural women with a median age of 54.0 (IQR, 47.0, 60.0).The average score of breast cancer in the study population was 73.0 (IQR, 66.0, 82.0). Among women in Southwest China, the awareness rates of knowledge on breast cancer symptoms, barriers to seeking medical help, and risk factors were 68.8%, 98.4%, and 62.1%, respectively. The awareness rate was found to increase with higher education levels (P<0.001) and decrease with increasing age (P<0.001). Multivariate logistic regression analysis identified three variables that might influence breast cancer awareness: education level, contraceptive measures, and history of breast disease (all P<0.05). Specifically, history of breast disease (Odds ratio (OR) = 1.907, 95% CI = 1.128 ~ 3.223), middle school education (OR = 2.155, 95% CI = 1.585 ~ 2.928), and junior college education and above (OR = 5.536, 95% CI = 1.898 ~ 16.148) were positive factors for women's breast cancer awareness. Conversely, the use of intrauterine devices (OR = 0.523, 95% CI = 0.384 ~ 0.712) was found to be a negative factor for women's breast cancer awareness. This study highlights the insufficient awareness of breast cancer among women in rural area of Southwest China. It emphasizes the necessity of health education to improve female breast cancer awareness.

To Study the Efficacy of Intrauterine Device and Endometrial Regeneration Therapy versus Endometrial Regeneration Therapy Alone in the Prevention of Adhesions after Hysteroscopic Resection of Uterine Septum

Abstract Background: Septate uterus is a very common defect of the female reproductive system. Septate anomalies are associated with diminished fertility and increased risks for adverse pregnancy outcomes. Treatment must aim for optimization of pregnancy outcomes with minimum adverse effects. The aim of this study was to compare the presence or absence of adhesions and assess the efficacy of intrauterine device (IUD) along with endometrial regeneration therapy (ERT) vis-a-vis ERT alone in the prevention of adhesions after hysteroscopic resection of septum. Objectives: (1) To compare the two groups with respect to their efficacy. (2) To analyze the side effects of therapy in each group, e.g., intermittent spotting/bleeding and cyclical pain. (3) To assess endometrial thickness after 3 months, i.e., preovulatory endometrium without therapy. This was a prospective observation study. Materials and Methods: A sample size of 42 was calculated for each study group for comparative analysis and subjects were randomly allocated into one of the two groups using computer-generated randomization tables. Group 1 received IUD and ERT while group 2 received ERT alone. Results: In first group receiving IUD + ERT therapy, 10 patients reported side effects in the form of hypomenorrhea, amenorrhea, severe pelvic pain and prolonged spotting as compared to only 8 patients developing side effects in the second group which received ERT alone therapy.: The rates of postsurgical intrauterine adhesion and other complications were not statistically significant in both groups (P = 0.457). There was no statistically significant difference between the groups with respect to preovulatory endometrial thickness. Conclusion: The findings from this clinical study reconfirm the results of already published efficacy and safety studies of the use of IUD and ERT preventive therapies following hysteroscopic metroplasty.

Contraindicated use of modern contraceptives among mothers from a Pelotas Birth Cohort.

To describe the prevalence of contraindicated use of combined hormonal contraceptives, progesterone-only contraceptives, and intrauterine devices in mothers participating in the 2015 Pelotas Birth Cohort according to the WHO medical eligibility criteria. The biological mothers of children belonging to the 2015 Pelotas birth cohort who attended the 48-month follow-up were studied. The 48-month follow-up data were collected from January 1, 2019, to December 31, 2019. Contraindicated use of modern contraceptives was considered to occur when these women presented at least one of the contraindications for the use of modern contraceptives and were using these methods. The prevalence of contraindicated use was calculated according to each independent variable and their respective 95% confidence intervals (95%CI). The analyzed sample consisted of 3,053 women who used any modern contraceptive method. The prevalence of contraindicated use of modern contraceptives totaled 25.9% (95%CI: 24.4-27.5). Combined hormonal contraceptives showed the highest prevalence of contraindicated use (52.1%; 95%CI: 49.3-54.8). The prevalence of contraindicated use of modern contraceptives methods was greater in women with family income between one and three minimum wages, a 25-30 kg/m2 body mass index, indication by a gynecologist for the used method, and purchasing the contraceptive method at a pharmacy. The higher the women's education, the lower the prevalence of inappropriate use of modern contraceptives. In total, one in four women used modern contraceptives despite showing at least one contraindication. Policies regarding women's reproductive health should be strengthened.

A Perforated Intrauterine Device and Laparoscopic Removal from the Omentum: Case Report

The intrauterine device (IUD) was a very common form of birth control in Tunisia and the world wide. The most serious potential complication of IUD use is uterine perforation. Clinical trials of Multiload Cu375 have reported an incidence of less than one uterine perforation per 1,000 insertions [1-3]. The recommended treatment is removal of the perforating IUD. This can usually be managed laparoscopically unless bowel perforation or other severe sepsis is present. We report a case of 45 years old woman carrying an IUD for 6 years which was referred from the family planning for IUD "lost". Upon vaginal examination, no IUD string was detected. An abdominal X-ray localised the IUD in a right iliac fossa. The device was identified and removed with a portion of the omentum. There is not an intestinal damage fortunately. The laparoscopic approach for intrauterine device removal has multiple purposes like identifing IUD, removing it and looking for eventuelly intestinal damages. It may be a simple and safe approach, thus minimizing possible postoperative complications.

Two Natural Births with Unremoved Iuds Causing Bladder Stone Formation Due to IUD Migration: A Rare Case

Background: Intrauterine Device (IUD) Multiload 375 is a method of contraception widely used worldwide. One of the rare complications is that the IUD punctures the uterus and moves into the bladder. Common manifestations are recurrent urinary tract infections and bladder stones. A long-term and neglected IUD increases the risk of uterine perforation and migration to other organs. Diagnosis: Clinical history, Cystoscopy, Transvaginal Ultrasound (US) or Computed Tomography helps confirm the diagnosis. Case Report: We report successful surgical treatment of a 39-year-old woman who neglected to insert a Multiload 375 IUD for 16 years, but still experienced 2 subsequent vaginal deliveries and eventually developed UTI. Bladder stone formation caused by the passage of the Multiload 375 intrauterine device through the bladder. Conclusions: Urologists should consider bladder foreign bodies as a displaced IUD in women with recurrent lower urinary tract infections or bladder stones, with a history of IUD use. The moving IUD needs to be removed through cystoscopy, laparoscopy, or open surgery. Proper monitoring and education for women’s health before and after IUD insertion helps to detect complications in a timely manner.

Menstrual cup use and intrauterine device expulsion in a copper intrauterine device randomized trial

ObjectiveTo evaluate menstrual cup use and intrauterine device (IUD) expulsion. Study designWe performed a secondary analysis of a 3-year contraceptive efficacy trial comparing two copper 380 mm2 IUDs. Investigators randomized participants approximately 1:4 to the TCu380A or NTCu380-Mini IUD. Approximately 12 months after enrollment began, we advised participants against menstrual cup use due to observed IUD expulsions in cup users. We evaluated IUD expulsion (including spontaneous partial and complete expulsion and accidental self-removal) at 12 and 36 months. We used multivariable logistic regression to evaluate IUD expulsion by age, baseline menstrual volume, body mass index, IUD type, menstrual cup use, parity, and uterine length. ResultsThis analysis included 1046 participants (203 TCu380A and 843 NTCu380-Mini), with 879 (84.0%) nulliparas. Through 12 and 36 months, expulsion occurred in 74 (7.1%, 95% CI 5.5–8.6%) and 133 (12.7%, 95% CI 10.7–14.7%) participants, respectively. Overall, 250 (23.9%) reported menstrual cup use. More menstrual cup users than non-users experienced expulsion through 12 months (32/203 [15.8%] vs. 42/843 [5.0%]) and 36 months (58/250 [23.2%] vs. 75/796 [9.4%]). Through 36 months, NTCu380-Mini menstrual cup users had higher expulsion odds, while TCu380A cup users did not. Menstrual cup users more frequently experienced accidental self-removal than non-users in participants using the TCu380A (3/53 [5.7%] vs. 0/150 [0.0%]) and the NTCu380-Mini (20/197 [10.2%] vs. 7/646 [1.1%]). In multivariable regression, we found increased odds of expulsion through 36 months in participants using menstrual cups with the NTCu380-Mini (aOR 3.13, 95% CI 1.16–8.46) and <25 years (aOR 1.59, 95% CI 1.07–2.34). ConclusionsWe found higher odds of IUD expulsion with menstrual cup and concurrent NTCu380-Mini IUD use over 36 months of use, but not with concurrent TCu380A IUD use. Menstrual cup users experienced higher likelihood of accidental self-removal regardless of IUD type. ImplicationsMenstrual cup and NTCu380-Mini use may increase IUD expulsion risk and may increase accidental self-removal risk with TCu380A and NTCu380-Mini use. Clinicians should advise patients of these risks and consider warning patients using an IUD shaped like the NTCu380-Mini (Nova-T frames) of expulsion risk with menstrual cup use.

Incidentally discovered extrauterine migration of a Lippes loop: should we let it stay?

Intrauterine devices (IUDs), a form of long-acting reversible fertility control, are often preferred for preventing pregnancy. The Lippes loops, made of plastic, are inserted into the uterus via the cervix, fitting into the uterine cavity. The non-medicated (inert) structure of the loop allows for long-term IUD use. Uterine perforation and translocation of the IUD are the most threatening complications. In this case report, we present an asymptomatic 79-year-old woman with a forgotten IUD that migrated into the abdominal cavity and was discovered during her follow-up for lung cancer.

Risk factors for antibiotic therapy failure in women with tubo-ovarian abscess: A systematic review and meta-analysis.

Medical therapy with antibiotics only and surgical drainage are the treatment options of tubo-ovarian abscess (TOA). It is not yet known exactly which cases need surgical treatment. The aim of this systematic review and meta-analysis was to evaluate the risk factors leading antibiotic therapy failure in women with TOA. We searched the following databases from inception to June 1, 2022: PubMed, Ovid MEDLINE, The Cochrane Library, and Scopus. We also searched reference lists of eligible articles and related review articles. The observational cohort, cross-sectional, and case-control studies were included in the meta-analysis. At least four review authors independently selected eligible articles, assessed risk of bias, and extracted data. The random effect model was used in the meta-analysis. A total of 29 studies, including 2890 women, were included in the study. The age, abscess size, history of intrauterine device use, postmenopausal status, history of diabetes mellitus, fever, white blood cell count, erythrocyte sedimentation rate, C-reactive protein level, and history of pelvic inflammatory disease were found as significant risk factors for antibiotic therapy failure in women with TOA. The findings of this study clarified the risk factors for antibiotic therapy failure in women with TOA.

Seroprevalence of Chlamydia trachomatis among Infertile Female Patients : A Cross-sectional Study

Introduction: Among many sexually transmitted pathogens, Chlamydia trachomatis (C.trachomatis) is increasingly being connected with long-term sequelae like infertility, in addition to its ability to cause genital tract infection. Aim: To determine the seroprevalence of C.trachomatis Infection (CTI) among the infertile female patients at a tertiary care centre. Materials and Methods: This was a cross-sectional study conducted from March 2019 to February 2020 at the Outpatient Department (OPD) of Reproductive Medicine and Surgery, Sri Ramachandra Hospital, SRIHER, Chennai, Tamil Nadu, India. Women with primary and secondary infertility were included in the study and their clinical history was collected in a proforma. Estimation of Immunoglobulin G (IgG) antibody by Enzyme Linked Immunosorbent Assay (ELISA) to C.trachomatis was done in the patient’s serum. Results: Out of the 130 female patients with infertility, 10 (7.6%) of them were positive for C.trachomatis IgG antibody. Among the 10 patients, five were primary infertility and the rest were secondary infertility. The most common risk factors were lack of awareness of contraceptive usage, young age, use of Intrauterine Device (IUD) and multiple sexual partners were generally associated with genital Chlamydial infection. Conclusion: The prevalence of C.trachomatis was 7.6% in the present study and was found to vary based upon the culture, hygiene and education. Hence, the present study recommends screening of IgG antibody by ELISA for C.trachomatis, which plays a significant role in the diagnosis of infertility.

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.

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.

Intrauterine devices are a safe form of contraception in users with solid organ transplantation: A single-center experience.

Patients who undergo organ transplantation are advised to use contraception for health optimization, yet limited data exists on safe contraceptive options for this population. This study investigates the infection risk of intrauterine devices (IUDs) in patients who have received a solid organ transplant by evaluating the incidence of pelvic inflammatory disease (PID). We performed a retrospective chart review of subjects with a solid organ transplant who used an IUD between the years of January 2007 to February 2021. We included subjects ages 22-55 years at the time of IUD placement. We abstracted demographic information, transplant type, IUD type, immunosuppressive medications, screening for sexually transmitted infections, and diagnosis of PID. We identified 29 subjects that met the inclusion criteria. Six subjects had a copper IUD (21%) and 23 had a levonorgestrel IUD (79%). The most common organ transplanted was a kidney (n = 10) and liver (n = 10) while five subjects had multiple organs transplanted. Twenty-five (86.2%) subjects took immunosuppressive medications at the time of IUD insertion. Twenty-four (82.8%) patients had their IUD placed after transplantation. The average time of IUD use was 2.5 years. . In our study of IUD use in patients with solid organ transplantation, no patients developed PID. IUDs are a safe contraceptive option for immunosuppressed transplant patients.

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.

Intrauterine Device Placement Success for Adolescents and Young Adults at Community-Based Reproductive Health Clinics

BackgroundDespite the endorsement of intrauterine device (IUD) use in adolescents and young adults (AYA) by leading professional organizations and demonstrated acceptance and desirability by AYA, clinicians may worry about procedural difficulty of IUD device placement in younger patients. ObjectiveThe aim of this study was to evaluate the clinical outcomes of first-attempt IUD placement in an AYA population by vaginal delivery (VD) history. Study DesignWe performed a retrospective cohort study of patients <25 years at reproductive health clinics with an IUD placement attempt between January 1-August 31, 2017. We abstracted sociodemographic characteristics, pregnancy history, and procedural characteristics including complications. Bivariate analyses compared successful first attempt IUD placement by VD history. We also assessed frequency of secondary clinical outcomes including ancillary measures used, provider type, symptoms reported during the procedure, and complications. ResultsWe included 1,325 participants (median age=21.3 years) including 42 (3.2%) with a prior VD. Nearly all IUD placements were successful at first attempt (n=1,301, 98.2%) and performed by advanced practice clinicians (n=1,314, 99.2%). First-attempt IUD placement success was similar in those participants with and without VD (p>0.999). Ancillary measures other than NSAIDS were used infrequently (n=16, 3.6%.) .(Among participants with an unsuccessful placement, 66.7% returned, and all had a successful IUD placement on the second attempt. Documented complications within six months of placement were rare (n=29) and mostly comprised of expulsions (n=27, 93.1%). ConclusionIUD placement success among AYA at community-based reproductive health clinics is very high and is not associated with a history of prior vaginal delivery.

Genital Infections and Associated Risk Factors in Women on Contraception Monitored at the Bacteriology and Virology Laboratory of Aristide Le Dantec Hospital

Background: Contraception is a strategy of choice for spacing births but also for avoiding early and unwanted pregnancies. However, through hormonal modification, this contraception constitutes a favorable state for the proliferation in the genital tract of agents responsible for vaginal infections. The objective of this study was to evaluate the prevalence of genital infections in women on contraception followed up at the bacteriology-virology laboratory of Aristide Le Dantec Hospital.&#x0D; Methods: This is a retrospective descriptive study conducted over a one-year period between January 2019 and December 2020. Microbial assessemnets were performed on genital secretions according to standard bacteriology laboratory procedures. Sociodemographic data and bacteriological examination results obtained were entered using File Maker Pro Advanced (version 16) software. Statistical analyses were performed using SPSS software (version 20).&#x0D; Results: This research studied 1771 women, of whom 1609 were on contraceptives. The most represented age group was over 40 years (27.06%). The majority of patients were women on oral contraceptives (32.07%). Women with secondary education (31.45%) and women with 1 to 3 children (43.03%) were most often on contraception. The germs most frequently detected in women on contraception were Gardnerella vaginalis (51.78%) and Candida albicans (24.19%) and the use of intrauterine device (IUD) as a means of contraception was statistically associated with vaginal infection (p=0.0004).&#x0D; Conclusion: This study showed a high frequency of vaginal infections in women on contraception and that the intrauterine device was significantly associated with the occurrence of these infections.

GAMBARAN TINGKAT PENGETAHUAN PASANGAN USIA SUBUR TENTANG PENGGUNAAN ALAT KONTRASEPSI IUD

Family Planning Program is an effort to create a quality family through promotion, protection and assistance in realizing reproductive rights as well as providing the necessary services, arrangements, and support. Acceptors of the Intra Uterine Device (IUD) still have misconceptions about the use of IUDs, which influences the use of IUD contraceptives. From several studies it was found that education can influence a person, including the acceptor's behavior in choosing a contraceptive method. The aim of this study was to determine the level of knowledge of couples of childbearing age regarding the use of IUD contraception. This type of research is quantitative with a descriptive analytical research design. The research location is UPTD Puskesmas I North Denpasar. The sample in this study was 176 couples of childbearing age, who were selected using a non-probability technique: purposive sampling. The research instrument used was a questionnaire with 10 knowledge questions about the use of IUD contraception. Data were analyzed with univariate tests. The research results showed data on the characteristics of respondents in the 20-35 years age range as many as 103 respondents (58,5%), SMA/SMK education was 112 respondents (63,6%), and private employment was 77 respondents (43,8%). The level of PUS knowledge in the use of IUD contraception was mostly in the good category with 122 respondents (69,3%).