IUD complications in perspective

All methods of contraception are associated with the risk of pregnancy and complications. Although there is extensive literature on complications associated with the use of IUD, there are some aspects of IUD use that require further study including pelvic actinomycosis, pelvic inflammatory disease, and tubal infertility. Each of these are reviewed briefly. Ways in which the use of currently available IUDs may be made safer are discussed.     

吉尼和吉妮致美宫内节育器取出原因及并发症分析

目的探讨吉尼和吉妮致美宫内节育器（IUD）的取出原因及并发症发生情况。方法回顾性分析取出吉尼和吉妮致美IUD的妇女455例,吉尼组311例,吉妮致美组144例,分析取出原因及出血、断裂、穿孔等并发症发生率。结果吉尼IUD和吉妮致美IUD取出主要的原因是月经过多和点滴出血,吉妮致美IUD断裂是取出困难的主要原因。结论吉尼IUD和吉妮致美IUD作为新型节育器应注意其取环的高危性。     

Septic pelvic complications with fatal outcome caused by an IUD

The most frequent complications resulting from IUD use are reviewed. Of the complications evaluated, pelvic inflammation is considered the most severe. During the past 11 years, 1 lethal septic complication occured in this department. It was caused by a pelvic inflammation. In that case, the pelvic inflammation manifested itself in a rather unusual form, and caused many problems in differential diagnosis. It is emphasized that the use of the IUD, although a modern and widely availabe method of contraception, is not free of complications. Such complications, however, might be reduced considerably by appropriate care. (author's modified)     

The emerging role of telemedicine in diagnosing and treating sleep disorders

Over one-third of adults are at risk of developing sleep disorders. Telemedicine is emerging as an effective tool in sleep medicine by allowing people to undergo sleep studies without overnight hospital stays (e.g. monitoring at home). Telemedicine has the potential to overcome several obstacles in the diagnosis and treatment of sleep disorders by offering increased access to sleep specialists, enhancing health-care support for patients in their homes and providing cost-effective professional education. The initial costs for telemedicine equipment and training are not insignificant; however, the benefits may outweigh the expense over time. However, recapturing the initial costs cannot be assumed.     

The norgestrel-T IUD

An improved long-acting Norgestrel-T contraceptive device has been developed. The effects of different release levels of levonorgestrel on the endometrium were studied in a selected group of 42 subjects.A randomized comparative study of the clinical performance of Cu-T 200 and Ng-T devices was undertaken in 200 fertile women for 15 months. Quantitation of the menstrual blood loss was performed on a selected group of 20 users. This new Ng-T device proved highly effective in fertility control. It was associated with a significant reduction in the amount of menstrual blood loss and incidence of termination probabilities due to bleeding and pain.     

花式IUD与爱母IUD应用效果分析

目的观察放置花式宫内节育器（HCu280IUD）与爱母IUD的临床使用效果。方法对自愿要求放置IUD避孕而无禁忌证的育龄妇女分别放置HCu280IUD和爱母IUD,各300例,分别于放置后3、6、12和24个月进行随访,比较两种IUD的脱落率、异位率、带器妊娠率、续用率及各种不良反应发生率。结果花式IUD与爱母IUD两种IUD年累积带器妊娠率分别为每百妇女年2．33和2．67,差异无统计学意义（P〉0｜05）;2年累积脱落率分别为每百妇女年3．0和10．0,差异有统计学意义（P〈0．05）;2年累积因症取出率分别为每百妇女年4．33和5．33,差异有统计学意义（P〈n05）;2年累积续用率分别为每百妇女年90．33和82．0,差异有统计学意义（P〈0．05）。结论花式IUD与爱母IUD两种IUD均具有较好的临床效果,其中花式IUD的不良反应更少,具有较好的有效性和可接受性。     

The Dalkon Shield IUD

The Dalkon Shield IUD was introduced to the list of contraceptives being distributed to developing countries by IPPF (International Planned Parenthood Federation) in 1973. By 1974, doubts had arisen about the safety of the Dalkon Shield and several cases of maternal mortality and sepsis in Dalkon Shield users had been reported. In 1974, IPPF stopped supplying Dalkon Shields to its affiliates. During the 1973-74 period of distribution, IPPF had distributed approximately 300,000 of the Shields in 41 countries. Almost 1/2 that amount had already been inserted. The position of IPPF's IMAP (International Medical Advisory Panel) on any relationship existing between use of IUDs and pelvic inflammatory disease is as follows as of 1980: 1) infection with actinomycosis makes up only a small component of all the incidents of pelvic inflammatory disease connected with IUDs; 2) the occurrence of pelvic inflammatory disease is not related to the length of use of an IUD; 3) data do not now support the recommendation that inert devices free from major side effects should be removed; and 4) any woman still wearing a Dalkon Shield should have it removed.     

The Silicone Shell IUD

The Silicone Shell IUD was evaluated in 487 patients during 6,448 women-months of use. The pregnancy rate was 1.5 per 100 women by the end of the first year. This device was compared with other devices used in our clinic with respect to pregnancy rate, expulsion, and excessive bleeding. During the short period of time covered by this study, no significant differences between the devices were noted.     

Early chorionic activity in women bearing inert IUD, copper IUD and levonorgestrel-releasing IUD

Early chorionic activity was assessed in the premenstrual days by means of serum HCG beta-fraction. As control, a group of women with no contraceptive use was studied; early chorionic activity was detected in 31.8% of the cycles. In the group bearing an inert IUD the incidence was 20%, which did not differ from the control; while in the medicated IUD groups (Cu-IUD and LNG-IUD) the incidences were 4.8% and nil, respectively. Both medicated IUD groups showed a significant difference when compared with the control, as well as the inert IUD groups. The meaning of these findings, pointing out differences in the main mechanism of action between inert and medicated IUDs, is discussed.