Gardyszewska Agnieszka, Niewiadomska-Kowalczyk Małgorzata, Szymańska Beata, Roszkowski Piotr, Czajkowski Krzysztof
II Katedra i Klinika Ginekologii i Połoznictwa, Warszawski Uniwersytet Medyczny.
Ginekol Pol. 2009 Dec;80(12):942-5.
Intrauterine contraceptive device (IUD) is a safe and effective method of contraception, widely used all over the world. The most common IUD complications include heavy bleeding, painful cramps, expulsion, complete or partial uterine perforation, infertility caused by pelvic inflammatory disease (PID), and an increased risk for septic and spontaneous abortion in cases of pregnancy with an IUD in situ. A potentially serious complication is the perforation of the uterus, with reported incidence of 0.5-1/1000 insertions. After perforation, devices have been found in various locations in the pelvis and abdomen. Between 2000 and 2008 there were five cases with mislocated intrauterine devices in our clinic. All patients were operated by laparoscopy and there was one conversion into laparotomy. Three patients were breast-feeding at the time. An average time between insertion and recognizing expulsion was 19.2 months. Missing strings during gynaecologic examination are the first sign of an expulsion. Transvaginal sonography combined with abdominal X-ray, is necessary to reach a definitive diagnosis. Laparoscopic treatment may be appropriate in most cases. IUD is a safe and effective method of contraceptive but its insertion may be connected with serious complications.
宫内节育器(IUD)是一种安全有效的避孕方法,在全世界广泛使用。最常见的宫内节育器并发症包括大量出血、痛经、排出、完全或部分子宫穿孔、盆腔炎(PID)导致的不孕,以及宫内节育器在位妊娠时发生感染性流产和自然流产的风险增加。一种潜在的严重并发症是子宫穿孔,据报道其发生率为每1000次放置中有0.5 - 1例。穿孔后,节育器可在盆腔和腹部的不同位置被发现。2000年至2008年期间,我们诊所发生了5例宫内节育器位置异常的病例。所有患者均接受了腹腔镜手术,其中1例转为剖腹手术。3例患者当时正在哺乳。放置节育器至发现排出的平均时间为19.2个月。妇科检查时尾丝缺失是节育器排出的首要迹象。经阴道超声检查结合腹部X线检查对于明确诊断是必要的。大多数情况下,腹腔镜治疗可能是合适的。宫内节育器是一种安全有效的避孕方法,但其放置可能会伴有严重并发症。