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[Endometrial cytology and copper containing intrauterine devices].

Copper-containing intrauterine devices (IUDs) for contraception are increasingly used within recent years. IUDs in situ provoke a non-specific inflammatory cell reaction, particularly at the glandular epithelium of the endometrium. The cellular changes include swelling of the cytoplasm and of the nuclei, the latter showing chromatin clumping, prominent nuclei and a pseudoeosinophilic reaction. Cytoplasmic changes exhibit vacuolation, incorporation of leukocytes and plasmolysis varying in degree. The local inflammation also accounts for the side effects associated with the device, such as uterine bleeding and endometritis. Cytomorphologically, the differentiation between cellular inflammation through IUDs and inflammatory metaplasia is difficult, particularly if the investigator has no information about the presence of an IUD. Intrauterine application of proteinase inhibitors can be helpful in differential diagnosis of such IUD-mediated cellular changes.

Aprotinin

A comparative study of the effect of the Progestasert TM and Gravigard IUDs on dysmenorrhoea.

Data obtained from questionnaires on the occurrence of dysmenorrhoea in women using IUDs inserted randomly (146 of them Progestasert and 149 Copper 7) are analyzed. In both groups a reduction in the intensity of menstrual cramps was observed over 12 months of use. Although these reductions are significant in each group, they are slightly higher in Progestasert users. However, on comparing the reduction tendencies of both groups, the difference between them is not significant. No significant differences become apparent either when comparing premenstrual and intermenstrual camps. The usefulness of simple questionnaires directed at detecting the nature of pain in currently used family planning forms for IUD users is discussed.

Actuarial Analysis

Effect of prior pregnancy and combined oral contraceptives on baseline menstrual blood loss and bleeding response to intrauterine devices.

No effect of pregnancy was found on baseline menstrual blood loss (MBL) in women within one year of parturition or abortion. The increased bleeding response of women to intrauterine devices (IUDs) was found to be independent of pregnancy status during the year preceding IUD sertion. Women pregnant within a year of insertion had no different MBL than those pregnant more than a year prior to insertion. MBL quantified in subjects within three months of discontinuing combined oral contraceptives (OCs) was significantly lower than in prior non-OC users. Furthermore, MBL was significantly reduced in the former group during the first three menses following IUD insertion. At the sixth and twelfth menses post-insertion, MBL was still lower in prior OC users, but the difference between users and non-users was less and no longer statistically significant.

Contraceptive Devices, Female

The influence of acetylsalicylic acid and paracetamol on menstrual blood loss in women with and without an intrauterine contraceptive device.

The influence of ASA and paracetamol on menstural blood loss and on some hematologic parameters was investigated in 23 women without an IUD and 10 women with an IUD. Neither in women with normal nor in women with small defects in the hemostatic mechanism were statistically significant increases in menstrual blood losses observed during treatment with ASA or paracetamol when compared to placebo. There was no linear correlation between bleeding time and basal menstrual blood loss or between the blood losses induced by ASA and paracetamol and the bleeding time.

Acetaminophen

Exogenous hormones and other drug exposures of children with congenital heart disease.

A history of oral contraceptive use, hormonal pregnancy tests, prescribed hormones and other drugs was obtained from 390 mothers of infants with congenital heart disease and 1254 mothers of normal infants in Massachusetts. The data show a small positive association between estrogen/progesterone exposure and cardiac malformation, the prevalence ratio estimate of exposed to non-exposed being 1.5 (90 per cent confidence limits are 1.0, 2.1). No association was evident, however, between hormones and trunco-conal or any other class of defect among the cases, an observation which casts doubt on a causal relationship betweem hormones and cardiovascular malformations. Several other drugs were reported more frequently by cases' mothers. These include: ampicillin; aspirin; a combined anti-nausea agent (doxylamine succinate, dicyclomine hydrochloride and pyridoxine hydrochloride); chlordiazopoxide, codeine, diazepam, diphenylhydantoin; insulin; phenobarbital; phenothiazine; phenylephrine; and tetracycline.

Estrogens

[Clinical, bacteriological and histological studies following several years of IUD use for contraception].

It is informed about clinical, bacteriological and histological examinations of 108 women who had used IUD's for 2 years. The examinations were carried out on the IUD and on the endometrium. We made use of the transcervical technic of taking out under sterile conditions. Pathological findings could only be fixed amongst 4 women in clinical view. In bacteriological view numerous germs of quite different kind were found at the same patient. Optional pathological germs as they also exist in the cervix were predominant. Of an infection was only spoken if in correspondence of the total material the same germ was found. This concerned only in 6% of the women. Histologically adequate findings resulted. Genuine inflammations were only considered in 6% of the examinated female patients.

Adult