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Clinical experience with Progestasert beyond one year of use.

A total of 254 women were enrolled in the study of the intrauterine progesterone system, Progestasert, and some of the subjects have been followed into the 8th year of use of the device. Clinical experience on 192 women in their 1st year of use of the device was reported in 1977. This follow-up study reports on 110 patients who had at least 2 insertions of the Progestasert for continuous use of 13 months, to a maximum of 8 insertions for continuous use of up to 86 months, for a total of 3808 months. 60% of subjects were nulliparous women who tolerated the device as well as the multiparous. The expulsion rate was low (3.5/100 women-years) noting that 82% of expulsions occurred within 2 months postinsertion or exchange of the device. A total of 7 pregnancies were observed; the pregnancy rate was 2.2/100 women-years. 2 of these 7 pregnancies were ectopic. No uterine or cervical perforations and no serious infections were observed.

Age Factors↗

Management of amenorrhea due to contraceptive injectables by temporary IUD insertion.

Amenorrhea is a common side effect of injectable contraceptive. Lippes loops were inserted in 22 amenorrheic women who continued injectable contraception, and in 6 cases with prolonged postinjectable amenorrhea. The occurrence and rhythm of subsequent bleeding was recorded. IUD insertion induced bleeding in most cases of continued injectable users but it was usually irregular and unpredictable. It was regular in 6 subjects only while the IUD was in situ. After the removal of the IUD, the majority regained the state of amenorrhea within 3 months. Temporary IUD insertion had a positive impact on continuation (a mean additional rate of 18 months of use) among subjects who had wished to terminate the method because of amenorrhea. This procedure of temporary IUD insertion may serve to provide these women with an alternative contractive approach. In the postinjectable amenorrhea group, temporary IUD insertion induced bleeding during IUD application as well as after its removal, which was more predictable than that in the continued users. IUD insertion may facilitate return of regular menses and resumption of fertility in amenorrheic women who stop injectable contraception.

Age Factors↗

Fincoid--a new copper IUD: a preliminary report.

Fincoid, a new copper IUD, was tested on a single clinic basis in a preliminary series of 956 1st insertions and 10,015 woman-months of use with an individual follow-up of 12 months. 458 (48%) of the women were nulliparous and 498 (52%) were parous. About 1/3 of the women had previously discontinued the use of other types of IUDs (mostly copper) because of side effects. The 1st segment of net cumulative rates for the whole series were: pregnancy 1.1, expulsion 4.7, removal for bleeding and/or pain 7.6 and removal for infection 0.8. The continuation rate was 78.9 and the percentage lost to follow-up was 2.8%. The parous group had a higher continuation rate (81) than the nulliparous group (76). Rates for pregnancy, expulsion, and infection in the nulliparous group were about 2-fold the corresponding rates of the parous group. There was no difference in the removal rate for bleeding and/or pain between the 2 parity groups. The results of the study show that the Fincoid is a valid method of intrauterine contraception.

Age Distribution↗

Pregnancy rates during long-term use of copper IUDs.

990 cases of women using standard copper IUDs (Cu 7; Cu T; Multiload) up to a maximum period of 8 years have been analyzed statistically. The long-term use effectiveness was evaluated mainly by using statistical methods (life table). Pregnancy rates decreased during the whole period of observation but more evidently after 2 years of use. It is recommended that medicated IUDs, free of side effects, be exchanged only after 5 years of use, corrosive changes being not too far advanced after this period. New IUD models are less likely to be subject to corrosion and will therefore need to be replaced less frequently.

Age Factors↗

Postpartum insertion of modified intrauterine devices.

The immediate postpartum insertion of standard intrauterine devices (IUDs) and those specially modified for postpartum use was evaluated in a multicenter clinical trial. The immediate postpartum insertion of IUDs was not associated with any increased risk of perforation or infection, although expulsion rates were higher than with interval insertions. The expulsion rate varied widely between centers using similar devices, suggesting that training in insertion is essential. Postpartum IUD insertions can be a practical contraceptive option for patients and providers of medical services.

Adult↗

Four years of experience with the TCu 380A intrauterine contraceptive device.

A study of the United States acceptors of the Copper T, model TCu 380A, initiated in 1972, was carried to the completion of 4 years of observation. The 1051 receptors, whose median age was 22.3 years, accumulated a total of 1927 years of use. At the end of 4 years, the cumulative net pregnancy rate was 1.9 per 100 women, and the gross rate was 2.8 per 100. The annual continuation rate over the 4-year interval averaged 77 per 100. The TCu 380A intrauterine device (IUD) has provided extremely effective and undiminishing protection against pregnancy through 4 years of use in a group of young women. This degree of protection has not as yet been equaled when randomized comparative trials have been carried out with other copper-bearing IUDs.

Adult↗