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宫内节育器在位妊娠(作者译)

[Pregnancies with intra-uterine devices in-situ (author's transl)].

作者信息

Obolensky W, Bucheli J

出版信息

Geburtshilfe Frauenheilkd. 1975 Aug;35(8):632-9.

PMID:1175906
Abstract

Pregnancies occurring with an intra-uterine device in situ were reviewed. Of 438 insertions since 1966, 31 patients became pregnant. 25 pregancies occurred with a Lippes Loop C or D of 277 insertions. Six pregnancies occurred with the Dalkon Shield among 161 patients. About 50% of the pregnancies occurred in the age group from 26 to 29 years and only 13% in the age group 20 to 25 years. Pregnancy did not occur in the age group below 20 years and in the age group above 40 years. The highest number of pregnancies occurred in Para 2's and Para 3's. 84% of all pregnancies occurred within the first 18 months after the insertion of the I.U.C.D. 13 of the pregnancies ended in therapeutic abortion and nine of these were combined with sterilization. Five pregnancies (about 20%) ended in a spontaneous abortion and one pregnancy ended in a premature delivery at 22 weeks. Five pregnancies went to term and three of these patients had tubal ligations post-partum. -- The three ectopic pregnancies are described in detail. There was one ovarian pregnancy, one tubal pregnancy and one pregnancy in the uterosacral ligament. -- The intra-uterine device is considered to be an acceptable method of contraception. The incidence of spontaneous abortion and ectopic pregnancy with an intra-uterine device in situ is increased. Because of the increased incidence of infertility following an ectopic pregnancy, the intra-uterine contraceptive device is only recommended with great reservation as a contraceptive method for nulligravidas.

摘要

对宫内节育器在位时发生的妊娠情况进行了回顾。自1966年以来的438例宫内节育器置入中,有31例患者怀孕。在277例置入Lippes Loop C或D型节育器的患者中有25例怀孕。在161例使用Dalkon Shield节育器的患者中有6例怀孕。约50%的妊娠发生在26至29岁年龄组,20至25岁年龄组仅占13%。20岁以下年龄组和40岁以上年龄组未发生妊娠。妊娠发生率最高的是经产2次和3次的妇女。所有妊娠中84%发生在宫内节育器置入后的前18个月内。13例妊娠以治疗性流产告终,其中9例同时进行了绝育。5例妊娠(约20%)以自然流产告终,1例妊娠在22周时早产。5例妊娠足月,其中3例患者产后进行了输卵管结扎。——详细描述了3例异位妊娠。分别为1例卵巢妊娠、1例输卵管妊娠和1例子宫骶韧带妊娠。——宫内节育器被认为是一种可接受的避孕方法。宫内节育器在位时自然流产和异位妊娠的发生率增加。由于异位妊娠后不孕发生率增加,宫内节育器作为未孕妇女的避孕方法仅在极为谨慎的情况下推荐使用。

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