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Results for “Intrauterine Device Expulsion”

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At least 19 recordsLinked to original sources

PubMedDate not supplied

[Factors for expulsion of intrauterine device Tcu380A applied immediately postpartum and after a delayed period].

OBJECTIVE: To determine the frequency of expulsion of the intrauterine device TCu380A (IUD) inserted either immediately postpartum or after a delayed period. We aimed to identify the factors associated with expulsion. MATERIALS AND METHODS: A longitudinal and comparative study was carried out in three Family Medicine Units of the Instituto Mexicano del Seguro Social (IMSS) of Leon, Guanajuato. One hundred twenty-five women who had a vaginal delivery and who elected to have IUD inserted immediately after delivery participated in the study along with 125 women who elected to have the IUD inserted after a delayed period after delivery. Studied factors were parity, technique, and insertion by the doctors assigned to the service and medical personnel in training (pre or postdegree). A medical review was performed one month and three months after insertion of the IUD. Results were analyzed by chi-square and Student t test. RESULTS: The expulsion rates of IUDs during immediate puerperium and also after a delayed period were 16 and 2.7%, respectively (p<0.0004). There was no statistically significant association between expulsion of the IUD and the following factors that were taken into account: age, primipara, personnel who inserted the device, and the application technique. In immediate puerperium, 25.9% of women who had multiple deliveries expelled the IUD, and in those who delayed IUD insertion, it was 4% (p=0.03). CONCLUSIONS: There is a greater risk of expulsion if the IUD is inserted immediately after delivery and it is associated with multiparity. The percentage of expulsion in immediate puerperium is similar to that reported in the literature.

Adult↗

PubMed1985

A study of delta intrauterine devices in Ankara, Turkey.

Delta devices, modifications of standard Lippes Loop D and TCu 220C IUDs, were designed for postpartum insertion. A study of the Delta T and the Delta Loop was conducted at Hacettepe University School of Medicine in Ankara, Turkey. The IUDs were randomly allocated to 246 immediately postpartum women (less than 10 min postplacenta). Twelve-month expulsion rates were low for both devices; 3.7 for Delta Loop users and 7.6 for Delta T users.

Female↗

PubMed1980

Post-coital intrauterine device insertion - a further evaluation.

A total of 191 patients have undergone post-coital insertion of an intrauterine contraceptive device up to ten days post-coitus. The majority of patients were nulliparous and underwent insertion of a standard Gravigard [Copper 7] device. The subsequent expulsion and medical removal rates were normal for this group of patients but the non-medical removal rates were higher. There was one possible post-coital contraceptive failure (0.6%) and one pregnancy at six months due to the device exhibiting a failure to conventional contraceptive action.

Coitus↗

PubMedDate not supplied

A comparison of the Lippes Loop and two copper-bearing intrauterine devices.

A review of published studies and studies conducted through the International Fertility Research Program on the Lippes Loop D, TCu and Cu-7 shows that none of the three devices evaluated is better with respect to continuation and all types of event rates. There is a trend toward lower expulsion rates for the copper-bearing IUDs, but other factors such as the cost of devices and the need for replacement must be considered in determining the merits of the devices for large-scale programs.

Evaluation Studies as Topic↗

PubMed1993

A multicenter study of the clinical performance of the Ortho Gyne-T380 Slimline intrauterine device in routine use in general practice and family planning clinics. UK Family Planning Research Network.

In a multiclinic use-effectiveness study, 505 parous women were fitted with an Ortho Gyne-T380 Slimline intrauterine device (IUD). Gross cumulative event rates, calculated by the Tietze-Potter life-table method, show the device to have a very low pregnancy rate and a low expulsion rate. The rate of removal following complaints of bleeding and/or pain was high. The incidence of infection was low and more likely to occur among younger users. The older parous women were more likely to have a satisfactory experience of IUD use than younger users. In accordance with current advice, and following a full discussion with the client, long-term use of the device beyond the manufacturer's recommended time period will continue among satisfied users.

Adult↗

PubMed1982

General assessment of the Multiload Cu250 intrauterine device. UK network of IUCD research clinics.

A total of 803 fittings of the Multiload Cu250 were undertaken between May and December 1979 in the UK IUCD network co-ordinated by the Institute of Population Studies. University of Exeter. Each woman fitted with the device was followed in a prospective study until a pregnancy, expulsion or removal occurred or the woman was released from follow-up after 2 years of continuous use. Because of the large number of fittings undertaken it is possible to compare the experience of groups of women determined by a number of criteria. The most useful distinction was between those of differing parity. Comparisons have been made between nulliparous women, women of low parity (1 or 2) and those of high parity (greater than or equal to 3). By concentrating on the characteristics of the woman receiving the IUCD it is possible to provide those responsible for fitting IUCDs with information that will have predictive value in relation to specific categories of women. The results of the study show that, despite some variation between women of different parity, the Multiload Cu250 is comparable with other IUCDs currently available in the UK in terms of the relative risks of pregnancy and removal of the device after a complaint of bleeding or pain. The removal rate is biased towards complaints of pain among nulliparous women which is also reported to be present at the times of IUCD fitting and removal. As expected with a device of this configuration, the expulsion rate is low when compared with other devices. Once into the uterus this device appears to be an effective contraceptive but fittings in nulliparous women more frequently necessitate dilatation of the cervix and this is associated with more frequent reports of difficulty at fitting and complaints of pain.

Female↗

PubMed1989

Randomized clinical trial with intrauterine devices (levonorgestrel intrauterine device (LNG), CuT 380Ag, CuT 220C and CuT 200B). A 36-month study. Indian Council of Medical Research Task Force on IUD.

A total of 1905 subjects were randomly allocated to four types of intrauterine devices (IUDs) and were observed for 45,683 woman-months of use. While no method failure was observed with levonorgestrel (LNG) IUD, 11 women became pregnant with other devices; 4 with Copper T 380Ag, 1 with Copper T 220C, and 6 while using Copper T 200B, indicating method failure rates of 1.0, 0.3 and 1.6, respectively, at 36 months of use. These rates were within acceptable range. Continuation rates were significantly lower with LNG IUD (74.5, 58.7, 38.8 at 1 year, 2 years and 3 years, respectively) as compared to other copper devices, which ranged between 82.4 to 84.4 at 1 year, 66.6 to 69.9 at 2 years and 45.4 to 50.4 at 3 years. The difference in continuation rates was mainly due to menstrual disturbances (e.g. amenorrhoea, irregular bleeding) which were higher with LNG IUD (27.9 per 100 users) as compared to the copper devices (13.4-15.4 per 100 users) at 36 months of use. The risk of expulsion ranged between 8.3 to 10.6 per 100 users and was comparable for all the devices. The observations from the present study based on 36 months of experience with different intrauterine devices do not indicate the need to replace CuT 200, the device currently in use in the National Programme.

Adolescent↗

PubMed1983

The introduction of postpartum intrauterine devices in the People's Republic of China.

In China, which has a commitment to family planning and, in particular, to the one-child family, a postpartum IUD should be widely accepted and could have significant impact on the Chinese family planning program. This report presents the introduction of the Delta T and Delta Loop devices, with 200 immediate postpartum insertions. Fifty-two deliveries were by cesarean section. The 6-month expulsion rates were 13.3 and 17.2 for the Delta T and Delta Loop, respectively. There was one pregnancy reported. Analysis suggests that the two devices are suitable for use in the postpartum period for Chinese women.

Adult↗

PubMed1975

Hormone-releasing silastic intrauterine devices: effect or provera-releasing intrauterine devices on two species of primates.

Silastic intrauterine contraceptive devices (IUDs) 13 mm long and 1.07 mm in diameter could be inserted easily into patas monkey uteri which, like human uteri, expelled them. Addition of 10% Provera to these devices did not reduce the expulsion rate significantly in our study. Control devices had no effect on cycle length in rhesus monkeys. After insertion, the active IUDs frequently caused a delay in onset of menstruation; however, cycles did occur with the device in situ, and normal-length cycles were resumed following removal of the device. A short period of rapid release (almost 35% of the total amount) of Provera from the device was followed by a longer period of sustained release of low levels of the hormone. Even 9 mug/day were sufficient to maintain a decidual reaction in the endometrium of the rhesus monkey. The drug could not be detected in the blood stream at 3,6, or 12 hours in patas monkeys or at 1 or 2 months in rhesus monkeys and so may never have reached the systemic circulation. Devices currently under study in baboons catain Provera or one of three other steroids to determine whether these compounds improve retention rates as well as meet the other two criteria set for the ideal IUD incorporation, for unless we meet this first criterion we can never achieve, let alone test, the others.

Animals↗

PubMed2002

Bleeding patterns and clinical performance of the levonorgestrel-releasing intrauterine system (Mirena) up to two years.

The objectives of this study were to evaluate the bleeding patterns and clinical performance during the first 2 years of use of an intrauterine system releasing 20 microg/day of levonorgestrel (LNG-IUS, Mirena). Two-hundred-fifty-six women accepted use of Mirena from April 1998 through September 1998. The gross cumulative discontinuation rate due to pregnancy and expulsion were significantly higher in women who used the device because of heavy bleeding. There was one pregnancy at the 15th month of use after an inadvertent expulsion of the device. The continuation rate was 66.2 at the end of the second year. Forty-four percent of women reported amenorrhea at the 6th month of use. This rate maintained stability at 50% after 12 and 24 months of use. Spotting was present in 25% of the users at 6 months, decreasing to 8% and 11% at 18 and 24 months, respectively. Oligomenorrhea was described by one-quarter of women and was similar at each observation period. Removals due to menstrual bleeding problems were concentrated in the first 6 months of use and mostly due to amenorrhea or menorrhagia. In conclusion, LNG-IUS showed a high contraceptive efficacy and a good continuation rate up to 2 years. In addition, a reduction of blood loss was observed a few months after insertion.

Adolescent↗

PubMed1976

A three-year trial of the Gravigard (Cu-7) intrauterine device.

The Gravigard (Cu-7) intrauterine device was evaluated in 201 patients (106 nulligravid, 20 nulliparous and 75 multiparous) for a period totalling 4,794 menstrual cycles. Only 4-9% of all insertions of the device proved difficult. Nine involuntary pregnancies occurred at a life-table rate of 3-0 +/- 1-3 per 100 women during the first year. Both pregnancies and expulsion of the device occurred more frequently in nulliparous than in multiparous women. Most expulsions of the device occurred during the first six months of use. A continuation rate of 72-6 per 100 women was achieved during the first year, of 58-2 per 100 women during the intial two years, and of 36-0 per 100 women during the three years of the trial. One of the most noteworthy features of this new IUCD is the extreme ease of its insertion in both nulliparous and multiparous patients.

Adolescent↗

PubMed1987

Observations on the mode of action of an intratubal device, the P-block.

A hydrogelic intratubal device, called P-block, Mark 9, was inserted hysteroscopically with local anesthesia in the intramural part of the fallopian tube of 25 women referred for the procedure as an alternative to abdominal sterilization. Hysterosalpingography revealing bilateral oviductal patency was followed by hysteroscopic checkup verifying bilateral presence of P-blocks, except in three patients who had expulsion of the P-blocks on one side. All of the 22 patients had retention of the P-blocks 6 to 7 months after insertion. None became pregnant. Thus it is suggested that an intratubal device in the isthmic part of the human fallopian tube acts as an intrauterine contraceptive device, preventing intratubal and intrauterine pregnancies. Endeavors to explain the contraceptive effect of a nonocclusive intratubal device are discussed on the basis of our present knowledge of tubal physiology. Distension of part of the human isthmus is likely to disturb normal gamete transport through the isthmus.

Adult↗

PubMed1977

Postabortion insertions of the pleated membrane.

The pleated or intrauterine membrane (IUM) was designed to fit a range of uterine sizes and shapes and to adjust to transient changes resulting from uterine motility. The retention and contraceptive abilities of postabortion IUM insertions are analyzed in this study of 154 IUM insertions made within 3 days of treatment for an incomplete or inevitable abortion. Results indicate low 1-year net cumulative event rates for pregnancy (1.7 per 100 users), expulsion (7.2 per 100 users), and removal for bleeding and/or pain (3.9 per 100 users). These rates were similar to those reported in a study of interval insertions of the IUM; moreover, these results also compared favorably with corresponding rates of postabortion insertions reported in studies using other devices. Thus, the postabortion period is indicated as being an effective time for IUM insertion.

Abortion, Induced↗

PubMed2000

Randomized comparative trial in parous women of the frameless GyneFix and the TCu380A intrauterine devices: long-term experience in a Chinese family planning clinic.

OBJECTIVE: To compare the clinical performance of two intrauterine devices (the frameless GyneFix intrauterine device (IUD) and the TCu380A IUD) during long-term use. STUDY DESIGN: This was a randomized comparative study. A total of 157 insertions of the GyneFix IUD were compared with 156 insertions of the TCu380A IUD in the Tianjin Municipal Institute for Family Planning, China. Only parous women were included in the study. Insertions were conducted by the first three authors. The trial extended over a 9-year period, with over 10,000 woman-months of experience. RESULTS: The study showed that both devices are highly efficacious. No pregnancies occurred with the GyneFix IUD (cumulative pregnancy rate 0.0), compared to one pregnancy with the TCu380A IUD (cumulative pregnancy rate 0.64). The cumulative expulsion rate with the GyneFix IUD was 1.91 (three expulsions occurred, two of which were during the first 6 months), compared to a cumulative expulsion rate of 5.13 (eight expulsions) with the TCu380A (p = 0.1112). The total use-related discontinuation rate (terminations were mainly due to bleeding disturbances) was significantly lower (p = 0.0051) with the GyneFix IUD (4.46) than with the TCu380A IUD (14.10) and resulted in a higher rate of continuation with the GyneFix IUD compared to the TCu380A IUD (92.36 versus 83.97). Neither perforations nor cases of pelvic inflammatory disease were encountered with either device in this study, demonstrating the safety of the anchoring system. CONCLUSION: The results of the present clinical trial are in agreement with the findings of other multicenter, randomized, comparative, clinical trials that have investigated these two IUDs in China, as well as with the findings of other large-scale international studies conducted with the frameless IUD.

Adult↗

PubMed1975

Comparison of three intrauterine contraceptive devices: the Antigon-F, the Ypsilon-Y, and the Copper-T 200.

A comparative study of three intrauterine contraceptive devices, the Antigon-F, the Copper-T, and the Ypsilon-Y, was carried out at The New York Hospital Cornell Medical Center during an 18-month period from March 1, 1972, through August 31, 1973. At the cutoff date of February 28, 1974, all patients had been followed for at least 6 months. During the period of study, 884 Antigon-F devices, representing 14,436 woman-months of use, were inserted. The over-all pregnancy rate was 0.88, with an explusion rate of 5.1 and a medical removal rate of 9.1/100 woman-years. This device was best tolerated by multiparous women. There was a total of 910 insertions of the Ypilson-Y, representing 14,348 woman-months of use. The over-all pregnancy rate was 1.8, with an explusion rate of 1.9 and a medical removal rate of 3.7/100 woman-years. The pregnancy rate in nulliparous women was 0.78, with a continuation rate of 88.9. The pregnancy rate in multiparous woman was higher, i.e., 2.4. Nine hundred thirty-nine Copper-T 200 devices, representing 15,558 woman-months, were inserted. The over-all pregnancy rate was 0.85, with an expulsion rate of 1.8, a medical removal rate of 4.5, and a continuation rate of 88.4/100 woman-years. The pregnancy rate was 0.82 for nulliparous women and slightly higher, i.e., 1.04, for multiparous women. Thus, all three devices had considerable merit. The Antigon-F and the Copper-T seemed the best in multiparous women; the Ypsilon-Y in the size used was best in nulliparous women. The only perforations occurred with the Copper-T.

Copper↗

PubMed1982

Interval iud insertion in parous women: a randomized multicentre comparative trial of the Lippes Loop D, TCu220c and the Copper 7.

A multicentre randomized clinical trial of the TCu220C, Lippes Loop D and Copper 7 was undertaken in nine WHO Collaborating centres for Clinical Research in Human Reproduction. A total of 984, 992 and 994 devices, respectively, were inserted between 1976 and 1978. The subjects were followed for two years. At this time 18,743, 17,013 and 17,927 woman-months experience had been accumulated with each device, respectively. The Lippes Loop consistently failed to perform as well as the TCu220C regardless of age or parity. The TCu220C had statistically significantly lower pregnancy rates at one and two years of use than either of the other two devices as well as lower expulsion rates. The TCu220C had lower removal rates at one and two years than the Lippes Loop and Copper 7. At one and two years the TCu220C had significantly higher continuation rates than the other two devices. It is concluded that the TCu220C is the device of choice amongst the three devices studied.

Adult↗

PubMed1989

Clinical performance of a levonorgestrel-releasing intracervical contraceptive device during the first two years of use.

One-hundred-and-ninety-eight women used a levonorgestrel-releasing intracervical contraceptive device (LNG-ICD) designed to release 20 micrograms levonorgestrel/day. Clinical performance during the first two years of LNG-ICD use was evaluated. A total of seven pregnancies occurred during the study period, all of them during the first year. Six pregnancies were after unnoticed expulsion of the device. One pregnancy occurred in an epileptic women using carbamazepine, with the LNG-ICD remaining in situ. Eighteen spontaneous expulsions occurred, 16 during the first year and 2 during the second year. Three pelvic infections were observed, all of them during the first year. Bleeding problems, hormonal side effects and other medical reasons were the most common side effects resulting in removal of the device. The continuation rate was 72.6 per cent after one year and 57.1 per cent after two years.

Female↗

PubMed1979

Combined and national experience of postmenstrual IUD insertions of Nova-T and Copper-T in a randomized study.

A randomized comparative study between Nova-T and Copper-T-200 was performed simultaneously in Denmark, Finland and Sweden. The results of 741 postmenstrual insertions with Nova-T and 780 with Copper-T are reported. The pregnancy rate of Nova-T was lower in every age and parity group. The pregnancy rate of Copper-T-200 varied in participating countries, whereas the pregnancy rate of Nova-T was equally low in every country. The termination rate because of expulsion with Nova-T was less affected by age and parity than that of Copper-T. Significant differences in the continuation rates with the same device were found between countries. Removals because of infection showed that women below 25 years of age had a high risk for infection regardless of parity.

Adolescent↗