Savasi Ingrid, Jayasinghe Kokum, Moore Patricia, Jayasinghe Yasmin, Grover Sonia R
Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital, Melbourne, Victoria, Australia.
J Pediatr Adolesc Gynecol. 2014 Feb;27(1):25-8. doi: 10.1016/j.jpag.2013.08.010. Epub 2013 Dec 4.
To assess the complication rates with the use of the levonorgestrel intrauterine system (LNG IUS) in adolescents with developmental disabilities.
Retrospective chart review of all adolescents with developmental disabilities taken to the operating room for LNG IUS insertion between January 2000 and July 2009 at the Royal Children's Hospital, Melbourne, Australia. Cases identified from the surgical database, and medical records reviewed.
Complication rates with LNG IUS use in adolescents with development disabilities: non-insertion, uterine perforation, infection, and expulsion.
Fifty-six adolescents with developmental disabilities had an attempted LNG IUS insertion. The average age at insertion was 15.6 years (range 10.5-21.5 y). The LNG IUS was used as first line therapy in 14 cases (25%). Pre-insertion ultrasonography was ordered in 48% of cases, out of which 5 cases had uterine lengths <6 cm. Despite this, 4 of these cases had successful insertions. Two insertion attempts were abandoned intra-operatively (3.6%); one due to inadequate uterine length of 4 cm, and the other due to anatomic distortion. One spontaneous expulsion occurred at approximately 5 months (1.9%). Four IUDs were removed prematurely (7.4% withdrawal rate); 1 for persistent abdominal pain, 1 for irregular bleeding, and 2 for suspected malpositions. There were no documented cases of infection, perforation, or pregnancy.
Our experience in this population has been very positive and confirms that complication rates are comparable to that in adults.
评估左炔诺孕酮宫内节育系统（LNG IUS）在发育障碍青少年中的并发症发生率。
对2000年1月至2009年7月期间在澳大利亚墨尔本皇家儿童医院因放置LNG IUS而进入手术室的所有发育障碍青少年进行回顾性病历审查。从手术数据库中识别病例，并审查医疗记录。
发育障碍青少年使用LNG IUS的并发症发生率：未成功放置、子宫穿孔、感染和节育器脱落。
56名发育障碍青少年尝试放置LNG IUS。平均放置年龄为15.6岁（范围10.5 - 21.5岁）。14例（25%）将LNG IUS用作一线治疗。48%的病例在放置前进行了超声检查，其中5例子宫长度<6 cm。尽管如此，这些病例中有4例成功放置。术中放弃了2次放置尝试（3.6%）；1例因子宫长度仅4 cm不足，另1例因解剖结构异常。1例在约5个月时发生自发脱落（1.9%）。4个宫内节育器被提前取出（取出率7.4%）；1例因持续性腹痛，1例因不规则出血，2例因疑似位置异常。没有记录到感染、穿孔或妊娠的病例。
我们在这一人群中的经验非常积极，并证实并发症发生率与成年人相当。
