Use Of Intrauterine Contraceptive Device Research Articles

Association of partner vasectomy, depot medroxyprogesterone acetate and intrauterine contraceptive devices with ovarian cancer

To assess the associations between ovarian cancer and depot medroxyprogesterone acetate (DMPA), intrauterine contraceptive devices (IUDs), and partner vasectomy. We undertook a New Zealand-wide population-based case-control study. During 2013-2015, 205 eligible cases were identified from the cancer registry (152 [74%] participated) and 1,735 eligible controls were randomly selected from the electoral roll (837 [48%] participated). A postal questionnaire was used to gather information. Ever-use of vasectomy was inversely associated with ovarian cancer in age-adjusted analysis, but not in multivariable analysis (OR=0.67, 95% CI=0.46-0.96, and OR=0.82; 95% CI=0.54-1.23, respectively). A suggestive trend towards lower risk with longer duration of reliance on partner vasectomy was observed (P-trend=0.08). Ever-use and duration of use of DMPA were not associated with ovarian cancer. Although ever-use of IUDs was not associated with ovarian cancer, duration of use of IUDs was associated with higher risk (P-trend=0.04). There were also statistically significant inverse associations between ovarian cancer and use of oral contraceptives, parity, and breastfeeding. Prolonged use of IUDs may increase the risk of ovarian cancer. It is also possible that an inverse association exists between ovarian cancer and partner vasectomy.

Assessment of intention to use postpartum intrauterine contraceptive device and associated factors among pregnant women attending antenatal clinics in ambo town public health institutions, Ethiopia, 2018

BackgroundMaternal mortality tragedy is the issue of both developed and developing countries, especially sub-Saharan Africa including Ethiopia, which is due to poor quality of maternal health care services. Therefore family planning especially the use of Postpartum intrauterine contraceptive devices can tackle unintended pregnancy and maternal death. However,the intention to use PPIUCD and the use of IUCD in general is not well practiced in Ethiopia according to evidences of the literatures. For this reason, many mothers are exposed to unintended pregnancy and pregnancy related complications. The main purpose of the study was to assess the intention to use Post-partum intra uterine contraceptive devices and its associated factors among pregnant women attending Antenatal Clinics in Ambo Town Public Health Institutions, Ethiopia, 2018.MethodsA facility-based cross-sectional study design was conducted from March – April 2018 to assess the intention of pregnant women about Postpartum intrauterine contraceptive devices and associated factors in 422 pregnant women. Study subjects were selected using systematic random sampling. Data were collected by structured questionnaire, entered into a computer using Epi-info 3.5.4 statistical program, and exported to SPSS version 20 for analysis. A Logistic regression model was used to predict the intention of pregnant women about Postpartum intrauterine contraceptive devices and associated factors. Lastly, a significant statistical association was tested using 95% confidence interval (CI) and p value (p < 0.05).ResultsThe response rate was 417 (98.3%) and this study showed that 145(34.9%) of pregnant women intended to use Postpartum intrauterine contraceptive device. Age of pregnant women [AOR = 8.348(CI: 3.602–19.347], educational level [AOR = 3.249(1.057–9.985)], occupational status [AOR = 4.101(CI: 1.788–9.405)], monthly income [AOR = 3.175(CI: 1.423–7.082)] and knowledge [A0R = 5.408(2.994–9.767)] have shown significant associations with intention to use Postpartum intrauterine contraceptive devices.ConclusionsThe study found that 34.9% women intended to use PPIUCD. Maternal age, maternal educational level, occupational status, monthly income and knowledge were significantly associated with pregnant women intention to use PPIUCD.

Family planning clients at a Tertiary hospital in Niger Delta, Nigeria: Where they on any contraceptive method prior to first visit?

Background: Maternal and child morbidity and mortality in developing countries have been shown to be reduced by effective use of contraceptive methods. Contraceptive use also improves the lives of women and children. Experience with previous use of contraceptives may affect the uptake rate of modern contraceptive methods. Aim and objective: To determine the pattern of previous contraceptive usage, uptake rates of the contraceptives, the continuation and discontinuation rates and the sources of prior contraceptives. The socio-demographic characteristics and sources of information on current contraceptive use at the Rivers State University Teaching Hospital during the study period. Methods: This was a retrospective study of clients’ records in family planning clinic at theRivers State University Teaching (RSUTH) over a period of five years. Their cards were retrieved, reviewed; data was extracted, coded and analyzed using the statistical package for social sciences (SPSS) IBM version25.0 (Armonk, NY). Results: There were 874 contraceptive acceptors attending family planning clinic between 1st January, 2015 and 31st December, 2019 in the centre. Of this number, 566 (64.8%) were using one form of contraceptive method or the other while 308 (35.2%) were not on any form of contraception. Of this 566 women who used contraceptive method prior to their visit to the family planning clinic, intrauterine contraceptive device (IUCD) use accounted for 118 (20.8%), others were barrier method, 107 (18.9%), oral contraceptive pills (OCPs), 95 (16.8%), depot medroxyprogesterone acetate (DMPA), 72 (12.7%), implanon, 40 (7.1%), noristerat, 36 (6.4%), postinor, 28 (5.0%), withdrawal method, 26 (4.6%) and calendar method, 24 (4.2%). Most of the previous contraceptives used came from Government hospital accounting for 44.4%. Most women (72%) obtained their information concerning current contraception from clinical personnel. More than half of the clients (64.1%) were within the age range of 30-39 years and 2 (0.2%) were below 20 years. Age range for the study was 19-51years. Majority of the clients (70.7%) were multipara while 162 (18.5%) were grandmultipara. Modal parity was para 3. The women with formal education were 867 (99.2%). Married women and Christians accounted for843 (96.5%) and 867 (99.2%) respectively. Conclusion: Most clients were in their thirties, married, educated and multiparous. Thirty five percent of the women were not using any form of contraceptive method which is quite alarming and definitely would have led to unwanted pregnancies and possibly induced abortions with its sequalae.

Marginal cord insertion among singleton births at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

BackgroundUmbilical cord may insert abnormally i.e. marginal insertion to a placenta which can cause different birth and perinatal complications. Despite the increased effort taken by different responsible bodies, the prevalence of birth and perinatal complications are still high, possibly due to anomalous cord insertion. So far, anomalous cord insertion lacks proper attention in different medical settings. Hence, the present study aims to assess the magnitude, risk factors, and adverse birth outcomes of marginal cord insertion among singleton births.MethodsAn institution-based cross-sectional study design was conducted. A systematic random sampling technique was used to select study participants. Data were collected by using a structured questionnaire and it was entered into epi-data version 3.1 then exported to SPSS version 20 for data cleansing and analysis. Bi-variable and multivariable logistic regressions were employed to identify risk factors and adverse outcomes associated with marginal cord insertions. Crude and adjusted odds ratio (P-value < 0.05) with a 95% confidence interval were calculated.ResultThe magnitude of marginal cord insertion was 6.4% (95% CI = 4.4–8.8%) in singleton pregnancies. Independent risk factors for marginal cord insertion were advanced maternal age (AOR = 2.24, 95% CI: 1.35–11.08), primiparity (AOR = 1.98, 95% CI: 1.37–8.69), maternal chronic hypertension (AOR = 3.07, 95% CI: 1.66–9.76), previous cesarean delivery (AOR = 2.51, 95% CI: 1.43–10.21), and use of intrauterine contraceptive device before pregnancy (AOR = 2.22, 95% CI: 1.36–12.30). Pregnancies complicated by marginal cord insertion are at higher risk to develop low birth weight (AOR = 2.89, 95% CI: 1.23–6.80), preterm birth (AOR = 4.00, 95% CI: 1.44–11.14), and emergency cesarean delivery (AOR = 3.68, 95% CI: 1.03–13.81).Conclusion and recommendationMarginal cord insertion is a mistreated potential risk for low birth weight, preterm birth, and emergency cesarean delivery. Routine screening of marginal cord insertion should be considered in pregnancies with advanced age, nulliparity, hypertensive disorder, history of cesarean section, and intrauterine contraceptive device usage before pregnancy.

Acceptability and Factors Associated with Immediate Postpartum Intrauterine Contraceptive Device Use Among Women Who Gave Birth at Government Hospitals of Gamo Zone, Southern Ethiopia, 2019.

BackgroundAn intrauterine contraceptive device is suitable for women of all reproductive age groups for preventing unwanted pregnancies. Immediate postpartum family planning (PPFP) services need to be emphasized when the woman leaves the hospital. Despite the accepted demand for PPFP, many women do not access the services. Therefore, this study aimed to assess acceptability and factors associated with immediate postpartum intrauterine contraceptive device use among women who gave birth at government hospitals of Gamo Zone, Southern Ethiopia.MethodsA cross-sectional study was conducted from March 1 to 30, 2019 with 452 participants studied using systematic random sampling technique. Data was collected using a pretested interviewer-administered questionnaire from March 1 to 30, 2019. The data were coded, cleaned and entered into Epi-data manager version 4.2.2.1 and exported to SPSS version 23 for advanced analysis. Binary logistic regression was performed to identify associated factors of immediate PPIUCD acceptability.ResultsThis study revealed that about 161 (35.6%) in 95% CI (31.0, 39.6) of the study participants accepted immediate PPIUCD. Multiparty (AOR = 2.33, 95% CI, (1.29, 4.20)), completed antenatal follow up (AOR = 3.65, 95% CI, (2.22, 5.99)), counselling (AOR= 8.38, 95% CI, (4.85, 14.48)) and prior discussion (AOR=2.57, 95% CI, (1.51, 4.36)) were statistically significant.Conclusion and RecommendationEven though 58% of the mothers were counselled about PPIUCD during the important cascade of pregnancy and 53% of the mothers completed antenatal service, efforts need to improve antenatal care services and integrate counselling services through the whole cascade of pregnancy.

Determinants of Postpartum Intrauterine Contraceptive Device Uptake among Women Delivering in Public Hospitals of South Gondar Zone, Northwest Ethiopia, 2019: An Unmatched Case-Control Study.

Introduction Integrated use of postpartum intrauterine contraceptive devices with delivery service during the immediate postpartum period is ideal for both women and health-care providers. However, utilization of intrauterine contraceptive devices during the postpartum period was rare and in Ethiopia, with information regarding uptake of postpartum intrauterine contraceptive devices limited. Objective Identify determinants of postpartum intrauterine contraceptive devices uptake among women delivering in public hospitals of South Gondar zone, Northwest Ethiopia, 2019. Methods An unmatched case-control study was conducted in public hospitals of South Gondar, Ethiopia, from August 1, 2019, to November 10, 2019. A total of 140 cases and 280 controls have actively participated in the study. Five hospitals were selected by simple random sampling. Cases were selected consecutively, whereas two controls for each case were recruited by the lottery method. Pretested questionnaires were used to collect data and it was entered into Epidata version 4.4.2. Logistic regression analysis was used to identify variables associated with the use of outcome and adjusted odds ratio with a 95% confidence interval was used to determine the association between independent and outcome variables. Results Completing secondary education (AOR = 4.5, 95%CI 2.3–8.85), having a total number of children of 3–4 (AOR = 3.6, 95%CI 1.25–10.2), having ≥ 5 (AOR = 4.7, 95%CI 1.5–15.3), attending 3 antenatal care (AOR = 2.8, 95%CI 1.44–5.6), ever hearing about postpartum IUCD (AOR = 6.6, 95%CI 2.7–16.1), and having counseling from health-care provider about a postpartum intrauterine contraceptive device (AOR = 6.2, 95%CI 2.99–12.8) were significantly associated with uptake of the postpartum intrauterine contraceptive. Conclusion and Recommendation. Completing secondary education, having 3–4 and ≥5 children, attending three antenatal care, ever hearing about postpartum IUCD, and having counseling from health-care providers about the postpartum intrauterine contraceptive device among women were significantly associated with uptake of an intrauterine contraceptive device after birth. Therefore, it is better to advise women to strictly follow their antenatal care, access to information, and provide counseling.

Hubungan Pendidikan, Usia dan Status Pekerjaan dengan Pemakaian Alat Kontrasepsi dalam Rahim (AKDR) di Puskesmas Pedamaran Kecamatan Pedamaran Kabupaten Oki Tahun 2019

Family planning programs are now urgently needed to prevent unwanted pregnancies and to improve the health and well-being of mothers and children. This study is to determine the relationship between education, age and work status simultaneously with the use of intrauterine devices (IUD) at Pedamaran Public Health Center, Pedamaran District, OKI Regency in 2019. This research is a quantitative research type descriptive research using a cross sectional approach with a sample size of 98 respondents. with systematic random sampling technique. The data was collected by looking at and recording data on family planning acceptors in the medical records where there were variables of education, age and work status using a checklist designed by the researcher. This research was conducted from March to August 2020. Based on the analysis, it was found that there was a significant relationship between education (ρ value 0.027), age (ρ value 0.005), work status (ρ value 0.026) and the use of intrauterine contraceptives (IUD) in Pedamaran Public Health Center, Pedamaran District, OKI Regency in 2020. The conclusion in this study can be seen that there is a relationship between education, age and employment status with the use of intrauterine contraceptives (IUD) at Pedamaran Puskesmas Pedamaran District, OKI Regency in 2019.

Ileal Perforation after Intrauterine Device Insertion

The intrauterine contraceptive device is the second most popular form of contraception worldwide. Uterine perforations may rarely complicate intrauterine contraceptive device use and are believed to occur mostly at the time of insertion. In the majority of cases, perforations are not recognized by the operator and remain asymptomatic. In rare instances however, severe delayed complications involving adjacent organs may ensue. We report an unusual case of uterine perforation with bowel injury diagnosed two years after the insertion of a copper intrauterine contraceptive device. We aim to address the use of transvaginal sonography to confirm proper intrauterine contraceptive device placement following a technically challenging insertion, clinical surveillance, and prompt removal of an intraperitoneal intrauterine contraceptive deviceto prevent potential serious complications, such as bowel embedment. Keywords: Bleeding; Bowel injury; Contraception; Intrauterine contraceptive device; Uterine perforations. Abbreviations IUD: intrauterine contraceptive device; G2P2: Gravidity 2 Parity 2

Lung cancer in women: is gynecological and obstetrical history important?

Introduction. Lung cancer remains the most frequent cause of death related to cancers, reaching 1.8 mln worldwide. We observe globally that the incidence of lung cancer in the never smokers affects women disproportionately more often than men. Material and methods. The aim of the study was to analyse the data about women suffering from lung cancer, with particular emphasis on their gynecological and obstetrical history. Women with confirmed primary lung cancer were evaluated (n = 29). Information about smoking, gynecological and obstetrical history was obtained from a self-administered questionnaire. Demographic data were also collected. Results. The most frequent lung cancer was adenocarcinoma (51.7%), followed by squamous-cell carcinoma (31.0%) and small-cell lung cancer (17.2%). Epidermal growth factor receptor (EGFR) mutations were present in 3 cases. The vast majority of women were smokers (89.7%) with median 30 pack years (IQR 20–48). Evaluating the TNM classification, the highest number of patients was classified to stage III (44.8%). The median age of menarche was 14 years, menopause — 50 years, the number of days with bleeding in the menstrual cycle — 4 and the length of the menstrual cycle — 28 days. An overwhelming majority of women have given birth to a child. Women reported extended menstrual cycles as the most frequent menstrual disorder (6 cases, 20.7%). Hormone replacement therapy and intrauterine contraceptive device use were declared in 10.3%. Conclusions. The results based on the small group of patients did not reveal any significant gynecological dysfunctions in our sample group with lung cancer.

Gastric Actinomycosis Case Report and Literature Review

Actinomycosis is an indolent infection that usually presents a diagnostic challenge to the physician. The most commonly affected zones are the cervicofacial, thoracic and abdominal areas. Abdominal actinomycosis although recognized for more than 150 years, is still wide unknown for most of the clinicians. Its various clinical manifestations are usually considered to present malignant process rather than infection. Intramural gastric actinomycosis is extremely rare clinical noosologic unit and usually the original source of infection is unknown. The usual clinical presentations include mild fever, epi- or mesogastric pain, weight loss, and bleeding from upper gastrointestinal tract. This chronic infection has tends to mimic malignancy. Gastric actinomycosis is very rare and with a good prognosis gastric disease. When established clinically, that is quite difficult diagnosis to be done before obtaining a surgical specimen. Although the findings are nonspecific, actinomycosis should be included in the differential diagnosis when CT scans show infiltrative mass with abnormal aggressiveness and dense enhancement of inhomogeneous contrast, especially in patients with leukocytosis, fever, or prolonged use of intrauterine contraceptives. We report a case of intramural gastric actinomycosis and review of cases of abdominal and gastric actinomycosis reported rarely in the literature. Reporting of such clinical case may help clinicians to increase the knowledge and awareness of this rare and treatable disease.

P49 First year expulsion rates and timing in obese and non-obese women after levonorgestrel 52 mg IUS placement

Objectives: Because obese women have higher expulsion rates than non-obese women with intrauterine contraceptive use, we investigated expulsion timing and rates in obese and non-obese women during the first year after levonorgestrel 52 mg intrauterine system (IUS) placement.

Hubungan Pengetahuan Ibu dengan Penggunaan Alat Kontrasepsi dalam Rahim (AKDR) di Puskesmas Putussibau Kabupaten Kapuas Hulu Tahun 2017

Introduction: The rapid population growth rate has encouraged the Family Planning Program which was developed forty years ago (1968), and has only been enjoyed in recent years. This support emerged after the campaign was carried out through the PKBI that had been formed. At the world level, the family planning movement has succeeded in reducing the number of children per family from 3.9 to 2 children, especially in developed countries. In Indonesia, the use of IUDs is also very small, around 4.35% of other contraceptives. Data for the last year in the Puskesmas Putussibau, where the new family planning participants were 588 IUD users, only 1.5% (9 people). Objective: To determine the relationship between maternal knowledge and use of intrauterine contraceptives in the working area of ​​Puskesmas Putussibau, Kapuas Hulu Regency in 2017.Research Methodology: This study used a cross-sectional design with a survey approach. This research was conducted from 7 to 28 October 2017. The sample of the study was 68 WUS people at Puskesmas Putussibau, Kapuas Hulu District. Data analysis used was the Spearmen-Rank to determine the relationship between variables with the use of the IUD with a value of p = 0.042 (x2 = 2.10), which means that the relationship between the variables is significant. Conclusion: The results showed that there was a relationship between knowledge and IUD use.

Risk-based screening to identify reproductive tract infection among HIV-infected women desiring use of intrauterine contraceptives

BackgroundReproductive tract infections (RTIs) are a major cause of morbidity and mortality, yet RTI testing remains limited in resource-constrained settings. We assessed performance of an existing RTI risk assessment screening...

Does contraceptive counseling during pregnancy increase self-reported use of hormonal, intrauterine, or permanent contraception in the first six months postpartum?

Does contraceptive counseling during pregnancy increase self-reported use of hormonal, intrauterine, or permanent contraception in the first six months postpartum?

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.

A twenty year experience with the use of intrauterine contraceptive device (IUCD) in a university teaching hospital in south-south Nigeria

Context: Contraceptive prevalence in Nigeria is low at 17%. Amongst Nigerian women and couples who accept to use contraception, the IUCD is the most commonly used contraceptive method with variation in rates of use between geographical areas and among Health Institutions. Factors that determine decision making on IUCD use are not well understood.&#x0D; Aims: To study the use, effectiveness, complications and discontinuation rates for intrauterine contraceptive device received at the University of Benin Teaching Hospital from 1997 to 2016 and analyzed in January, 2019.Study Design: This was a retrospective cross sectional study.&#x0D; Methodology: The case notes of all 3326 new clients who accepted Copper T intrauterine contraceptive device at the UBTH Family Planning Clinic during the review period were retrieved and analyzed. Data regarding acceptors socio-demographic characteristics, side effects, effectiveness, complications, duration of use and reasons for discontinuation were extracted and entered into SPSS for windows version 22.0 and analyzed.&#x0D; Results: Out of the 8203 clients that accepted to commence a family planning method, 3326 (40.55%) accepted to use IUCD. The mean age of IUCD acceptors at commencement was 33.4±5.60 and the mean age of their husbands was 39.85±6.91. The mean parity was 3.73±1.87 (range 0-12), while the mean number of living children was 3.56±1.66 (range 0-10). The mean duration of use (in months) was 40.43±40.13. Women with 5 or more children (P Value 0.000) and at least a minimum of secondary education (P Value 0.000), were significantly associated with IUCD use duration of &gt; or more than 2 years. Also, women who reported satisfaction with IUCD (P Value 0.000) and no complications (P Value 0.000) were also associated with longer duration of use.&#x0D; Conclusion: IUCD is a common family planning method used by women at UBTH. Its duration of use is higher among clients with more children, at least a minimum of secondary school education and no complications from its use. This information is relevant for family planning service providers to increase contraceptive uptake by women in Nigeria.

Intrauterine Devices: A Review

An intra-uterine device is a special device that fits inside of the uterus. Intrauterine contraceptive device (IUD) is the most commonly used method of contraception in many countries. The IUDs are a long-acting reversible method of contraception. Despite the availability of many generations of IUDs with variable shapes and configurations, side effects and complications are frequent. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Currently hormonal IUDs are available in the market. Each IUD is extremely effective, convenient, and safe. The newer IUDs have been tested in populations not usually included in clinical trials and provide reassuring answers to older concerns about IUD use in these women, including information about expulsion, infection, and discontinuation. On the other hand, larger surveillance studies have provided new estimates about the risks of complications such as perforation, especially in postpartum and breastfeeding women.

The Rate of Intrauterine Contraceptive Device Use and Associated Factors Among Married Women of Reproductive Age in Mettu Rural Community, Southwest Ethiopia.

Background: Intrauterine device (IUD) is the second most commonly utilized modern family planning method in the world next to female sterilization. It is the most cost-effective, safe, long-lasting, rapidly reversible method of contraception, but only 2% of married women are using the IUD in Ethiopia. Objective: To assess the rate of IUD use and associated factors among married reproductive age women in Mettu rural community, Southwest Ethiopia. Methods: A community-based cross-sectional study was done among 501 married reproductive age women in Mettu rural district, Southwest Ethiopia from April to May 2018. Data were collected by using an interviewer-administrated questionnaire. Bivariate and multiple variable logistic regression analysis were employed. Results: Twenty-one (4.1%) women were currently using the IUD. Women’s primary education, adjusted odds ratio (AOR) 4.40 (95% C.I 1.32-14.64); secondary and above education, AOR 5.05 (95% C.I 1.11-22.01); having favorable attitudes, AOR 3.24 (95% C.I 1.06-9.89); absence of myth and misconception, AOR 3.40 (95% C.I 1.23-9. 39); having discussion about IUD with women health development army, AOR 3.11 (95% C.I 1.02-9.49); and possessing more than 2 children AOR 3.48 (95% C.I 1.31-9.27) were positively associated with IUD utilization. Conclusion: Only 1 in 25 women was using an IUD. Sociodemographic factors (education and number of children) and behavioral factors (attitudes, myths, and misconceptions) were found to be significant predictors. Scientific community should explore the local contexts of intrauterine use in different parts of Ethiopia.

Inflammatory diseases of pelvic organs and longed use of intrauterine contraception (clinical case)

The article emphasizes the etiology, pathogenesis and complications of pelvic inflammatory diseases in the use of intrauterine contraceptives (IUD). The risk of inflammation is higher in the first weeks of the use of IUD. The urgency of the problem is shown by the example of the case from the practice of the gynecological department of Khujand regional clinical hospital (Republic of Tajikistan).

CLINICAL CASE OF SILENT UTERINE PERFORATION AFTER INNECTORAL CONTRACEPTIVES PLACEMENT IN ANAMNESIS

The most dangerous complication when using intrauterine contraceptives is the perforation of the uterus. According to the WHO expert group, uterine perforation in contraceptive carriers is associated with significant frequency fluctuations (one case per 1509,000 placements). The frequency of perforations depends on the type of contraceptive, the material from which it is made, as well as on the anatomical features of the uterus (retroflexion of the uterus, scar narrowing and deformation of the cervical canal, deformation of the external cervical os after diathermocoagulation of the cervix, etc.).Uterine perforation usually occurs in three places: at the bottom of the uterus, in the corner between the cervix and its body and at the wall of the cervix (WHO data, 2005).A clinical case of "silent uterine perforation" has been published to avoid or reduce the incidence of complications with the placement and use of intrauterine contraceptives. The article presents a clinical case of detected uterine perforation with uterine contraceptive, which has been asymptomatic for 10 years and has been diagnosed as an accidental finding during surgery for large size uterine fibroids. The anamnesis data, description of the clinical picture and features of the course of surgery are given; ways of prevention of this complication are discussed. Analyzing the clinical case, the authors concluded that in order to prevent the above complications, it is necessary to verify the localization of the intrauterine contraceptivewith the ultrasound after its placement. In case of difficulty in removing the intrauterine contraceptive, this procedure may be performed under the control of a hysteroscope.