BibTex RIS Kaynak Göster

Is History Of Previous Multiload 375 Iud Expulsion A Risk Factor For Levonorgestrel-Releasing Intrauterine Device Users?

Yıl 2013, Cilt: 10 Sayı: 38, 1582 - 1585, 01.04.2013

Öz

Objective: Although intrauterine devices IUDs is one of the most frequently used contraceptive methods, the pregnancy rate is estimated between 1 and 3 per 100 woman-years. Third generation copper IUDs and the levonorgestrel-releasing device LNG-IUD are both safer than conventional IUDs with a low failure rate. The contraceptive efficacy of an IUD is thought to be related to its position in the uterine cavity. In previous reports expulsion was associated with a significantly higher risk for a re-expulsion in IUD patients. Although several trials examined the rate of multiload 375 IUD and LNG-IUD expulsions, none have evaluated the partial and complete expulsion rates of the LNG-IUD in previously dislocated multiload 375 IUD users. Materials and method: This prospective study involved a total of 127 LNG-IUD inserted patients. In 57 patients Multiload 375 IUD have previously dislocated n=57, study group and in 70 patients IUD have never been applicated control group . Transvaginal ultrasound was used to monitor the LNG-IUD position immediately after insertion, 10 days after and later on at 6 months intervals for a 2 years follow-up. Results: Demographic characteristics of groups were similar. Hypermenorrhea was not found to be associated with an increased dislocation rate in LNG-IUD users. We detected only one dislocation in study group and two dislocations in control group 1,8% vs 2.8%, p>0.05 . Conclusion: History of previous Multiload 375 IUD expulsion was not found to be a risk factor for LNG-IUD failure. With a very low dislocation rate LNG-IUD might provide a higher contraceptive efficacy than other IUDs.

Kaynakça

  • Luukkainen T, Lahteenmaki P, Toivonen J. Levonorgestrel-releasing intrauterine device. Ann Med 1990; 22:85–90.
  • Luukkainen T. Levonorgestrel-releasing intrauterine device. Ann NY Acad Sci 1991; 626:43–9.
  • Sivin I, el Mahgoub S, McCarthy T, et al. Long- term contraception with the levonorgestrel 20 mcg/day (LNg 20) and the copper T 380Ag intrauterine devices: a five-year randomized study. Contraception 1990;42:361– 78.
  • Thonneau P, Goulard H, Goyaux N. Risk factors for intrauterine device failure: a review. Contraception 2001;64:33–7.
  • Petta CA, Faundes D, Pimentel E, Diaz J, Bahamondes L. The use of vaginal ultrasound to identify copper T IUDs at high risk of expulsion. Contraception 1996;54:287–9.
  • Rivera R, Chen-Mok M, McMullen S. Analysis of client characteristics that may affect early discontinuation of the TCu-380A IUD. Contraception 1999;60:155–60.
  • Bahamondes L, Diaz J, Marchi NM, Petta CA, Cristofoletti ML, Gomez G. Performance of copper intrauterine devices when inserted after an expulsion. Hum Reprod 1995;10:2917–8.
  • Castro A, Abarca L, Rios M. The clinical performance of the Multiload IUD. I. The influence of the endometrial cavity length. Adv Contracept 1993;9:285–90.
  • Zhang J. Factors associated with copper T IUD removal for bleeding/pain: a multivariate analysis. Contraception 1993;48:13–21.
  • Anteby E, Revel A, Ben-Chetrit A, Rosen B, Tadmor O, Yagel S. Intrauterine device failure: relation to its location within the uterine cavity. Obstet Gynecol 1993;81:112–4.
  • NICE. National Institute for Health and Clinical Excellence. Long-acting Reversible Contraception (2005)
  • Suhonen S, Haukkamaa M, Jakobsson T, Rauramo I. Clinical performance of a levonorgestrel- releasing intrauterine system and oral contraceptives in young nulliparous women: a comparative study. Contraception 2004; 69:407–12.
  • Baveja R, Bichille LK, Coyaji KJ, et al. 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. Contraception 1989;39:37–52.
  • Andersson K, Odlind V, Rybo G. Levonorgestrel- releasing and copper-releasing (Nova T) IUDs during five years of use: a randomized comparative trial. Contraception 1994;49:56–72.
  • Sivin I, Stern J, Coutinho E, et al. Prolonged intrauterine contraception: a seven-year randomized study of the levonorgestrel 20 mcg/ day (LNg 20) and the copper T380 Ag IUDs. Contraception 1991;44:473–80.
  • Diaz J, Pİnto Neto AM, Bahamondes L, Arce XE, Castro S. Performance of the copper T 200 in parous adolescents: are copper IUDs suitable for these women? Contraception 1993;48:23-28.
  • Jallis JRG, Lye SJ. Estrogen and progesterone during pregnancy and parturition. In: Fraser IS, editor. Estrogens and progestogens in clinical practice. London:Churchill Livingstone; 1998.p. 243-54.

Önceki Multiload 375 Rahim İçi Araç Atılımı Levonorgestrel Salgılayan Rahim İçi Araç İçin Risk Faktörü Müdür?

Yıl 2013, Cilt: 10 Sayı: 38, 1582 - 1585, 01.04.2013

Öz

Amaç: Rahim içi araç RİA , en sık kullanılan doğum kontrol yöntemleri biri olarak kullanılmasına karşın gebelik oranı yıl başına 1-3/100 kadın olarak tahmin edilmektedir.. Üçüncü nesil bakır RİA ve levonorgestrel salan cihaz LNG-RİA gebelik oranlarının düşüklüğü ile geleneksel RİA’dan daha güvenlidir. RİA’nın gebelik önleyici etkinliği rahim boşluğu içindeki konumu ile ilgilidir. Önceki yayınlarda multiload 375 RİA ve LNGRİA yerinden çıkmaları değerlendirilmişse de, daha önce multiload 375 RİA çıkmış olanlarda, LNG-RİA’nın tam çıkma ya da kısmi yer değiştirmeleri incelenmemiştir. Gereçler ve Yöntem: Bu prospektif çalışma toplam 127 LNG-IUD takılmış hastayı içermektedir. 127 hastanın çalışma grubunu oluşturan 57’sinde daha önce Multiload 375 RİA atılımı öyküsü mevcutken çalışma grubu , 70 hastada daha önceden RİA atılımı öyküsü yoktur kontrol grubu . LNG-RİA konumunu izlemek için transvajinal ultrasound RİA takılmasından sonraki 10. gün, 6 aylık aralıklarla ve toplamda 2 yıllık izlemler olacak şekilde değerlendirilmiştir. Bulgular: Grupların demografik özellikleri benzerdir. Hipermenore, LNG-RİA kullananlarda artmış yer değiştirme ile ilişkili bulunmadı. Çalışma grubunda bir LNG RİA atılımı ve kontrol grubunda iki atılım % 1,8'e karşılık % 2.8, p> 0.05 tespit edildi. Sonuç: Önceki Multiload 375 RİA atılımı LNG-RİA başarısızlığı için bir risk faktörü olarak bulunmamıştır. Yerinden oynama riskinin çok düşük olduğu LNG-RİA, diğer RİA’lardan daha yüksek kontraseptif etkinlik sağlayabilir.

Kaynakça

  • Luukkainen T, Lahteenmaki P, Toivonen J. Levonorgestrel-releasing intrauterine device. Ann Med 1990; 22:85–90.
  • Luukkainen T. Levonorgestrel-releasing intrauterine device. Ann NY Acad Sci 1991; 626:43–9.
  • Sivin I, el Mahgoub S, McCarthy T, et al. Long- term contraception with the levonorgestrel 20 mcg/day (LNg 20) and the copper T 380Ag intrauterine devices: a five-year randomized study. Contraception 1990;42:361– 78.
  • Thonneau P, Goulard H, Goyaux N. Risk factors for intrauterine device failure: a review. Contraception 2001;64:33–7.
  • Petta CA, Faundes D, Pimentel E, Diaz J, Bahamondes L. The use of vaginal ultrasound to identify copper T IUDs at high risk of expulsion. Contraception 1996;54:287–9.
  • Rivera R, Chen-Mok M, McMullen S. Analysis of client characteristics that may affect early discontinuation of the TCu-380A IUD. Contraception 1999;60:155–60.
  • Bahamondes L, Diaz J, Marchi NM, Petta CA, Cristofoletti ML, Gomez G. Performance of copper intrauterine devices when inserted after an expulsion. Hum Reprod 1995;10:2917–8.
  • Castro A, Abarca L, Rios M. The clinical performance of the Multiload IUD. I. The influence of the endometrial cavity length. Adv Contracept 1993;9:285–90.
  • Zhang J. Factors associated with copper T IUD removal for bleeding/pain: a multivariate analysis. Contraception 1993;48:13–21.
  • Anteby E, Revel A, Ben-Chetrit A, Rosen B, Tadmor O, Yagel S. Intrauterine device failure: relation to its location within the uterine cavity. Obstet Gynecol 1993;81:112–4.
  • NICE. National Institute for Health and Clinical Excellence. Long-acting Reversible Contraception (2005)
  • Suhonen S, Haukkamaa M, Jakobsson T, Rauramo I. Clinical performance of a levonorgestrel- releasing intrauterine system and oral contraceptives in young nulliparous women: a comparative study. Contraception 2004; 69:407–12.
  • Baveja R, Bichille LK, Coyaji KJ, et al. 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. Contraception 1989;39:37–52.
  • Andersson K, Odlind V, Rybo G. Levonorgestrel- releasing and copper-releasing (Nova T) IUDs during five years of use: a randomized comparative trial. Contraception 1994;49:56–72.
  • Sivin I, Stern J, Coutinho E, et al. Prolonged intrauterine contraception: a seven-year randomized study of the levonorgestrel 20 mcg/ day (LNg 20) and the copper T380 Ag IUDs. Contraception 1991;44:473–80.
  • Diaz J, Pİnto Neto AM, Bahamondes L, Arce XE, Castro S. Performance of the copper T 200 in parous adolescents: are copper IUDs suitable for these women? Contraception 1993;48:23-28.
  • Jallis JRG, Lye SJ. Estrogen and progesterone during pregnancy and parturition. In: Fraser IS, editor. Estrogens and progestogens in clinical practice. London:Churchill Livingstone; 1998.p. 243-54.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Aylin Aker Ayrim Bu kişi benim

Nilgün Öztürk Turhan Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 10 Sayı: 38

Kaynak Göster

Vancouver Aker Ayrim A, Öztürk Turhan N. Önceki Multiload 375 Rahim İçi Araç Atılımı Levonorgestrel Salgılayan Rahim İçi Araç İçin Risk Faktörü Müdür?. JGON. 2013;10(38):1582-5.