Steroid reservoir loss during removal of perforated Levonorgestrel 52 mg intrauterine device

Steroid reservoir loss during removal of perforated Levonorgestrel 52 mg intrauterine device

A 22-year-old G1P1 Caucasian female had hysteroscopic removal of a perforated intrauterine device during which the steroid reservoir of the intrauterine device was lost. Isolated steroid reservoirs are radiolucent on plain film radiography. We located the reservoir in the peritoneal cavity with magnetic resonance imaging and removed it via laparoscopy.

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Society of Family Planning clinical recommendations: contraception after surgical abortion

Andrea Hsu Roe, Deborah Bartzb

Contraception Journal - January 1, 2019

September 06, 2018 - Published

IUDs can be safely placed at the time of surgical abortion and do not increase the risk of infection or perforation. IUD expulsion rates are significantly higher after second-trimester surgical abortion than after first-trimester surgical abortion, but expulsion rates after first-trimester surgical abortion may not differ significantly from interval placement.

Excerpts from Abstract

These recommendations present an evidence-based assessment of provision of contraceptives at the time of surgical abortion. Most methods of contraception, including the intrauterine devices (IUD), implant, depot medroxyprogesterone injection, oral contraceptive pill, contraceptive patch, monthly vaginal ring, barrier methods and some permanent methods, can be safely initiated immediately after first- or second-trimester surgical abortion. Provision of postabortion contraceptives, particularly IUDs and implants, substantially reduces subsequent unintended pregnancy. IUD insertion immediately following uterine aspiration is safe. While this may be associated with a higher risk of device expulsion than with interval placement, expulsion rates remain low, and this risk must be weighed against the fact that patients often do not receive their desired IUD at an interval insertion and therefore experience higher rates of subsequent unintended pregnancy. Many patients experience barriers that prevent access to the full spectrum of postabortion contraceptive options, particularly IUDs and implants. Advancements in health-systems-based point-of-care provision and policies are needed to improve comprehensive contraceptive availability following surgical abortion. These recommendations will address clinical considerations for postabortion contraceptive provision and recommend interventions to improve contraceptive access following uterine evacuation.

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Contraception

An International Reproductive Health Journal

Wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion.

The Management of a patient with a fragmented intrauterine device embedded within the cervical canal - Case Report

The Management of a patient with a fragmented intrauterine device embedded within the cervical canal - Case Report

A 28-year-old woman presented with a malpositioned intrauterine device (IUD) that was fragmented and significantly entrenched within the cervical canal and myometrium. IUD malposition with concomitant device fragmentation and embedded segments, albeit rare, should be a consideration given the device's prevalence.

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Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices

Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices

Because adolescents are at higher risk of sexually transmitted infections (STIs), obstetrician–gynecologists should continue to follow standard guidelines for STI screening. They should advise adolescents who choose LARC methods to use male or female condoms consistently (dual method use) to decrease the risk of STIs, including human immunodeficiency virus (HIV). Obstetrician–gynecologists should counsel all sexually active adolescents who do not seek pregnancy on the range of reversible contraceptive methods, including LARC, and should help make these contraceptives readily accessible to them.

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Recent intrauterine device use and the risk of precancerous cervical lesions and cervical cancer

Recent intrauterine device use and the risk of precancerous cervical lesions and cervical cancer

Recent levonorgestrel-IUD use may be associated with CIN2, a lesion with a high rate of regression, but not CIN3, which is considered a true pre-cancerous lesion. The observed association between levonorgestrel-IUDs and CIN2+ was modest but warrants further investigation. It may have clinical importance for contraceptive counseling if this finding is shown to be consistent across other studies and other populations.

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Factors associated with low-lying intrauterine devices: a cross-sectional ultrasound study in a cohort of African-American women

Factors associated with low-lying intrauterine devices: a cross-sectional ultrasound study in a cohort of African-American women

Women who are obese may benefit from additional counseling and closer follow-up after IUD placement. Future research is warranted to investigate IUD placement and possible IUD migration among women who are obese.

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Perforation risk and intra-uterine devices: results of the EURAS-IUD 5-year extension study

Perforation risk and intra-uterine devices: results of the EURAS-IUD 5-year extension study

The overall perforation rate was 2.1 per 1000 insertions for LNG-IUS users 1.6 per 1000 insertions for copper-IUD users……. LNG-IUS users had a borderline higher risk of perforation compared with copper-IUD users.
Forty-five (58%) of the 77 perforations were associated with suspected risk factors……
Breastfeeding…… and time since delivery remained significant risk factors in perforations detected after 12 months.
No perforations resulted in serious injury to intra-abdominal or pelvic structures.

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Information sur le dispositif intra-utérin Mirena - Point d'information

Information sur le dispositif intra-utérin Mirena - Point d'information

Tout effet indésirable suspecté d’être lié à l’utilisation du dispositif intra-utérin Mirena peut être signalé, par les patientes ou les professionnels de santé, en tant qu’effet indésirable associé à un médicament sur https://solidarites-sante.gouv.fr/soins-et-maladies/signalement-sante-gouv-fr/ .

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Chronic Systemic Toxicity Study of Copper Intrauterine Devices in Female Wistar Rats

Chronic Systemic Toxicity Study of Copper Intrauterine Devices in Female Wistar Rats

The aim of this study was to evaluate the chronic systemic and local toxicity of a copper intrauterine device in a rat model. These results obtained at different dosages and long-term implantation provide solid data confirming the safety of long-term use of Cu-IUDs. However, the elevated leucocyte levels found in this study warrant further investigation.

Includes lots of references to other studies.

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Jaydess IUS Study

Jaydess IUS Study

Jaydess should be used with caution after specialist advice, or removal should be considered in women with existing or new severe headache, migraine, jaundice, severe arterial disease such as stroke or myocardial infarction, or marked increase in blood pressure.

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Migration of Intrauterine Devices: Radiologic Findings and Implications for Patient Care

Migration of Intrauterine Devices: Radiologic Findings and Implications for Patient Care

Intrauterine devices (IUDs) are a commonly used form of contraception worldwide. However, migration of the IUD from its normal position in the uterine fundus is a frequently encountered complication, varying from uterine expulsion to displacement into the endometrial canal to uterine perforation.

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