Document Detail


Intraperitoneal levonorgestrel-releasing intrauterine device following uterine perforation: the role of progestins in adhesion formation.
MedLine Citation:
PMID:  12721174     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intrauterine contraception is a widely used, highly effective means of birth control. Uterine perforation is a serious, albeit rare, complication of intrauterine device (IUD) use. Although uterine perforation by levonorgestrel-releasing (20 micro g/day) intrauterine system (LNG-IUS) has already been reported, the peritoneal adhesion potential of this IUD is unknown. METHODS: The medical files of all patients diagnosed with an intra-peritoneal IUD between the years 1990-2002 at Hadassah Medical Center were reviewed. Histopathological study of peritoneal adhesion tissue adjacent to levonorgestrel medicated IUD was conducted in one case. RESULTS: Eight cases of dislocated IUDs were found. Four cases used LNG-IUS and four other cases used copper-IUD. Laparoscopy for IUD removal disclosed mild local peritoneal adhesions between omentum and pelvic organs in all cases. No difference was noted in the appearance of the peritoneum in the presence of either a copper-IUD or LNG-IUS. Histological examination of peritoneal tissue encasing the levonorgestrel-intrauterine system revealed loose connective tissue with aggregates of submesothelial cells with a pseudo-decidual change. Immunohistochemical staining for progesterone receptor was negative. CONCLUSIONS: The peritoneal adhesions potential of LNG-IUS is low, similar to that of the copper-bearing IUD.
Authors:
Ronit Haimov-Kochman; Victoria Doviner; Hagay Amsalem; Diane Prus; Amiram Adoni; Yuval Lavy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  18     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-04-30     Completed Date:  2004-01-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  990-3     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology and Department of Pathology, Hadassah University Hospital, Jerusalem, Israel. rkochman@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Contraceptive Agents, Female / administration & dosage*
Copper
Female
Foreign-Body Migration / etiology*
Humans
Intrauterine Devices, Medicated / adverse effects*
Levonorgestrel / administration & dosage*
Peritoneal Diseases / etiology
Peritoneum* / pathology
Progestins / metabolism
Retrospective Studies
Tissue Adhesions / etiology
Uterine Perforation / etiology*,  pathology
Chemical
Reg. No./Substance:
0/Contraceptive Agents, Female; 0/Progestins; 7440-50-8/Copper; 797-63-7/Levonorgestrel

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