Document Detail


Intrauterine device developments.
MedLine Citation:
PMID:  12313225     Owner:  PIP     Status:  MEDLINE    
Abstract/OtherAbstract:
Results of recent IUD research are presented. The largest study of postpartum IUD insertion to date, a multicenter comparative trail involving 3791 women at 15 sites in 13 countries, has shown that the practice is safe and effective if the IUD is correctly placed. Modifications in design of the device are unnecessary to reduce expulsions. In 1977, Family Health International (FHI) began developing IUDs that would have clinically acceptable expulsion rates following postpartum insertion. By adding chromic catgut suture material to the upper arms of the TCu andLippes Loop, FHI developed the Delta T and Delta Loop. Many of the centers involved in studies of postpartum IUD insertion were large urban maternity hospitals in developing countries with heavy caseloads of 10,000-30,000 deliveries/year. Results of the trials and of a 19-center evaluation of the timing of postpartum insertion support several conclusions: 1) insertion should take place within 10 minutes of placental expulsion; 2) if insertion is done within 10 minutes of delivery, there is no increased risk of infection or uterine perforation; 3) the type of device inserted is less important than the method of insertion; expulsion rates at different clinics ranged from 6-37/1000 women at 6 monts, and the fundal placement of the device is crucial; and 4) expulsions are higher for postpartum than interval insertions but not so high as to make the offer of an IUD immediately postpartum unacceptable. Since the incidence of pain or bleeding associated with IUD use is related to their size, attempts to decrease the side effects have centered on development of smaller copper devices. 1 such device, the copper i, consists of a straight stem with small crossarms in an 'x' configuration disigned to anchor the IUD in place. A copper wire around the stem of the device exposes 200 sq millimeters of cooper. A study of 98 women who used the Copper i showed an accidental pregnancy rate of 3.2 at 6 months and 9.0 at 12 months, and an expulsion rate of 15.8 at 12 months. Although the data and clincal impressions indicate that the goal of reducing menstrual effects was achieved, the pregnancy and expulsion rates were unacceptably high. An IUD recently developed at FHI is a modification of the Copper T IUD and features threads attached to the lower cervix end of the IUD but directed toward the uterine fundus or crossarms of the IUD. The inverted strings are intended to minimize risks of pelvic inflammatory disease. Future availability of the device depends on results of clinical trials. A 2nd invention is an IUD retriever which makes possible the removal of IUDs without marker strings as well as IUDs whose strings have retracted into the utering cavity.
Authors:
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Network (Research Triangle Park, N.C.)     Volume:  5     ISSN:  0270-3637     ISO Abbreviation:  Netw Res Triangle Park N C     Publication Date:  1984  
Date Detail:
Created Date:  1985-02-06     Completed Date:  1985-02-06     Revised Date:  2012-08-17    
Medline Journal Info:
Nlm Unique ID:  9509506     Medline TA:  Netw Res Triangle Park N C     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  4-6     Citation Subset:  J    
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MeSH Terms
Descriptor/Qualifier:
Contraception*
Developing Countries
Diagnosis*
Economics
Family Planning Services*
Intrauterine Devices*
Postpartum Period*
Reproduction
Research*
Technology
Therapeutics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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