1.Expulsion rate of immediate versus early postpartum intrauterine device insertion after vaginal delivery: A cross sectional study
Jennifer Mary Joy V. Chiu ; Mildred D. Torres
Philippine Journal of Obstetrics and Gynecology 2019;43(6):1-7
Background:
Progressively increasing population of the country leads to unmet needs for responsible parenthood. This is reflective to reproductive age women with unplanned pregnancies which may consequently lead to maternal morbidity and mortality and adverse perinatal outcomes. Provision of family planning methods is implemented. One of the temporary methods of Long Acting Reversible Contraception (LARC) is Intrauterine Contraceptive Device (IUD). The effectiveness is similar to tubal sterilization with its perfect use. However, one of the drawbacks is dealing with its expulsion which affects its efficacy.
Objective:
The study determined the expulsion rate between Immediate and Early postpartum IUD insertion after vaginal delivery. Expulsion rate was evaluated during the following periods: prior to discharge, after 4 weeks, after 12 weeks and 24 weeks post-insertion.
Methodology:
This was an Observational Cross Sectional Study conducted for a year designed to collect data among patients who had IUD insertion after vaginal deliveries in a 6-month period of follow up. Sample size was computed using epi info 7.0. Finite Population Collection was derived to meet the population size available which resulted to 159 participants. Randomization was initiated to classify between immediate and early IUD insertion. Expulsion was observed during follow up at the family planning center of the institution
Results:
This data showed no direct correlation in the expulsion rates between early and immediate postpartum IUD insertion. The expulsion rate was 6.25% for Immediate and 5.55% for Early IUD insertion respectively. There were no expulsion observed beyond 12 weeks post insertion. Relationship between early/immediate IUD insertion and expulsion rate was investigated using Chi square test.
Conclusion
Improved education and heightened awareness among reproductive aged women would initiate higher acceptance of IUD during postpartum period. Proper and improved technique of IUD insertion during postpartum period may decrease expulsion rate hence promoting better utilization of this family planning method.
Intrauterine Devices
2.Wandering intrauterine contraceptive device: An unusual travel to the sigmoid colon
Kumarappan Alagappan ; Karthikeyan Marthay ; Gunaseelan Durairaj ; Ros'aini
The Medical Journal of Malaysia 2015;70(5):312-313
Intrauterine contraceptive device (IUCD) is common choice
for contraception. Migration of IUCD is one of the
complications that are encountered. Here we report a case
of IUCD migration to the sigmoid colon. A 39-year-old Malay
lady carrying a copper T type of IUCD presented with
missing thread then underwent examination under
anaesthesia, proceeded to hysteroscopy but failed removal.
Abdominal ultrasound detected it in the left lower quadrant
of abdomen. She then underwent diagnostic laparoscopy
where the device was found to be embedded in the sigmoid
colon. Technical difficulty necessitated conversion to mini
laparotomy and sigmoidotomy to remove the IUCD and the
bowel closed primarily. IUCD is a relatively simple and safe
contraceptive procedure but possible complications are
bleeding and pain that usually co-exist, pelvic infection,
expulsion and perforation. Investigations should be based
on clinical suspicion and migrated IUCD in symptomatic
patients should be surgically removed whereas,
asymptomatic patients can be managed conservatively
under certain circumstances. However in the presence of a
concurrent pathology that requires exploration then retrieval
of the migrated IUCD should be undertaken.
Intrauterine Devices
3.Laparoscopic Removal of an Intrauterine Contraceptive Device That Had Migrated into the Intraabdominal Cavity.
Youn Jung HEO ; Won Woo KIM ; Sang Kuon LEE ; Hae Mung JEON ; Eung Kook KIM
Journal of the Korean Surgical Society 2000;59(5):683-685
The migration of an intrauterine contraceptive device (IUD) into the intraabdominal cavity is rare. However, the removal of such as IUD is recommended for the major reason of an intraabdominal inflammatory reaction and possible bowel obstruction or perforation. We report a case of migration of an IUD into the intraabdominal cavity, which was detected twenty-four years after insertion. The IUD was successfully removed by using laparoscopic surgery on an ambulatory basis.
Intrauterine Devices*
;
Laparoscopy
4.Intrauterine insemination among Filipino couples with processed total motile count of 1.0 x 106 or less: Semen quality profile and prognosis for pregnancy
Fernandez Ma. Asuncion A. ; Libalib-Madamba Ma. Lorely M.
Philippine Journal of Reproductive Endocrinology and Infertility 2009;6(2):41-54
Objective: To determine the pregnancy rate after intrauterine insemination using samples with. processed total motile count of 1.0 x 106 and less and describe the semen quality profile of Filipino males with severe male factor infertility in both the raw and processed semen samples.
Design: Retrospective descriptive study.
Setting: Andrology Laboratory, St. Luke's Medical Center. Patients: 307 infertile Filipino couples who underwent 426 IUI cycles.
Main Outcome Measures: Pregnancy rate (PR) after intrauterine insemination.
Results: A total of 10 pregnancies were obtained out of 426 IUI cycles, for a pregnancy rate per cycle of 2.4%. Seven of these eventually delivered to term, for a live birth rate of 1.6%. Among those who did not get pregnant with IUI, 8 had spontaneous pregnancies within 1 to 5 year period of follow-up for a spontaneous pregnancy rate of 1.9%. As expected, all the semen parameters analysed showed improvement after semen processing in all subjects. However, these improvements failed to result in a more acceptable pregnancy rate. Among the parameters, morphology was notably better among those who had pregnancies.
Conclusion: The chance of pregnancy with IUI using semen samples with processed total motile count of 1.0 x 106 or less is relatively low. For these couples, it may be more prudent to proceed directly to IVF-ICSI than to try several cycles of IUI in futility.
INTRAUTERINE INSEMINATION
;
SEVERE OLIGOSPERMIA
5.Patterns of intrauterine device use among family planning acceptors seen in the outpatient Department of a Tertiary Hospital
Mariemids S. Isidro ; Maria Antonia E. Habana
Philippine Journal of Reproductive Endocrinology and Infertility 2019;16(2):48-52
Intrauterine device is a popular means of reversible birth control in the world. In the Philippines,
Copper T intrauterine device (IUD) supplies may come from private sources but the bulk has been
from the public sector. The public sector gets IUD for free and inserts them at virtually no cost.
Although the IUD has been known for decades, there is still low utilization despite its effectiveness
and safety. It is worthwhile to determine the dynamics of IUD use. This study reviewed the use of
IUD among women consulting the Family Planning Unit of a tertiary university hospital.
It is necessary to evaluate the clients’ needs both by improving the accessibility and quality of
services and intensifying information dissemination on available family planning services. This
is especially true for those who already want to limit their children but do not want to undergo a
permanent method.
Intrauterine Devices
;
Contraception
6.Sonographic features and clinical correlates of correctly positioned and malpositioned intrauterine device in women examined at a tertiary hospital: A five year review
Regina Rosario M. Panlilio-Vitriolo ; Nur Ainee D. Kamensa
Philippine Journal of Obstetrics and Gynecology 2020;44(5):20-28
Background:
Transvaginal ultrasound prior to IUD insertion may be helpful in appropriate patient selection and optimal patient conditions in preventing IUD malpositions and complications.
Objective:
To describe the sonographic features of correctly positioned and malpositioned intrauterine device (IUD) in women and correlate with associated symptoms and concurrent cervical, uterine and ovarian pathology
Methodology:
This is a 5-year retrospective cross-sectional study. Patients in a tertiary hospital with sonographically detected correctly positioned and malpositioned IUDs were selected from the Obstetrics and Gynecology Ultrasound Database from January 1, 2014 to December 31, 2018. The patient’s name and case number were used to review the patient’s charts for the demographic profile and other necessary data. Intrauterine device sonographic features were recorded, correlated clinically and analyzed statistically.
Results:
Three hundred two patients were eligible for the study with ages between 41 to 50 years old and with an average of 1 to 3 pregnancies and livebirths. Almost half of the women with malpositioned IUDs complained of missing IUD string. Sonographically, the IUD appeared echogenic with more than half demonstrating a linear echogenic stripe. The most common type of malpositioned IUD was partial or fully embedding the myometrium (45.2 %), followed by those located in the cervix or in the lower uterine segment (35.7%), partially expelled with IUD segment extending through the external cervical os (11.9%), and fragmented (4.7%). The least common malpositioning was malrotation of the IUD (2.3%). There were significantly more women with cervical disease among those who had correctly placed IUDs. Thirteen women were pregnant, 9 of whom had intrauterine pregnancies. 3 had ectopic pregnancies and 1 had an abortion. Eight of the 9 intrauterine pregnancies had malpositioned IUD and only 1 had correctly positioned IUD which was statistically significant.
Conclusion
Women with IUD who became pregnant and with missing IUD strings are important predictors to re-assess IUD placement. Uterine pathologies such as myomas and adenomyomas do not affect placement of intrauterine devices. IUDs remain in place in the presence of cervical diseases such as cervical malignancies.
Ultrasonography
;
intrauterine devices
;
7.Prevalence and determinants of long‑acting reversible contraception initiation among teenage mothers in a tertiary hospital
Ma. Shenny Joy A. Santiago ; Mona Liza B. Pastrana
Philippine Journal of Obstetrics and Gynecology 2022;46(5):210-217
Background:
According to the WHO, about 16 million girls at the age of 15–19 years give birth each year. In the Philippines, 600 live births a day are registered under teenage mothers. At Mariano Marcos Memorial Hospital and Medical Center, 12% of all obstetric admissions yearly are teenagers. The American College of Obstetricians and Gynecologists recommends long‑acting reversible contraception (LARCs), in the form of intrauterine device and progestin subdermal implant as pregnancy prevention options for young mothers. The objective of the study was to identify the prevalence and determinants of long‑acting reversible contraception (LARC) initiation among teenage mothers in Mariano Marcos Memorial Hospital and Medical Center.
Methodology:
Prospective observational study: A self‑administered questionnaire was given to the respondents wherein they ranked determinants involved in their selection of a contraceptive method on a scale of 1–4 (1 being the most important, and 4, the least important.
Results
A total of 162 teenage mothers participated in the study. Majority of the respondents were 17–18 years old, enrolled up to high school, single, unemployed, and primiparas. Eighty‑seven percentage of all teenage mothers admitted at Mariano Marcos Memorial Hospital and Medical Center from December 2020 to December 2021 used long‑active reversible contraception. Ranked from most (1) to least (4) important, the respondents considered: (1) Effectivity, (2) Long duration, (3) Family influence, and (4) Peer influence as their determinants for initiating LARC method. The high effectiveness and long duration of LARC were the primary reasons for initiation, while the least factors they considered were that of peer and family influence.
Intrauterine Devices
;
Pregnancy in Adolescence
8.Assessment of intrauterine device using (IDU) and factors affecting IUD acceptance in the period 1995-2000 in Vietnam
Journal of Practical Medicine 2004;487(9):33-39
Study 4,203 bearing-age women who had used intrauterine devices (IUDs). Results: using IUDs is the most common contraceptive methods in Vietnam. Women used this method are usually in bearing-age and have more frequent intercourse (under 35 years old: 63.8%), have had baby (100%). 24.4% of them have used other methods. Factors affected IUDs acceptance are safe (40.5%), convenient (44.4%), easy to use (31.6%), and being provided information and counseling (84%).
Intrauterine Devices
;
Epidemiology
;
Vietnam
;
Women
9.A clinical trial of four different models of multiload copper intrauterine contraceptive device in Korean women.
Hyun Mo KWAK ; Chan Ho SONG ; Dae Hyun KIM ; Dong Jae CHO ; Hyock Dong HAN ; Kum Ja PARK ; Mi Young KWAK ; Mi Suck LEE
Korean Journal of Obstetrics and Gynecology 1991;34(8):1106-1117
No abstract available.
Copper*
;
Female
;
Humans
;
Intrauterine Devices*
10.A curious case of missing couplet IUCDs
Mridula A BENJAMIN ; Aruna KEKRE
Brunei International Medical Journal 2012;8(4):189-192
Intrauterine contraceptive device (IUCD) is one of the most widely used family planning methods. Although considered to be generally safe, it can be associated with problems such as missing IUCD. There have been many reports of isolated missing IUCD but reports of two missing IUCDs in the same patient are very rare. We report the case of a 35-year-old lady with such an occurrence that was diagnosed incidentally on a routine kidney, ureter and bladder (KUB) radiography.
Complications
;
Contraception
;
Intrauterine Device Migration