Gupta Swati, Malik Shashiprateek, Sinha Renuka, Shyamsunder Saritha, Mittal M K
Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Associated Safdarjung Hospital, New Delhi, India.
Department of Radiodiagnosis, Vardhman Mahavir Medical College and Associated Safdarjung Hospital, New Delhi, India.
J Obstet Gynaecol India. 2014 Oct;64(5):349-53. doi: 10.1007/s13224-014-0532-5. Epub 2014 Apr 23.
Incorrectly placed copper T 380A leads to increased contraception failure. This study aimed to find an association between the ultrasonographic position of the copper T 380A in the immediate postpartum period and the adverse effects observed during the period of 6 months after its insertion.
This descriptive study was carried out in the Department of Obstetrics & Gynaecology of a tertiary-care-center of India from September 2011 to February 2013. The women eligible for immediate postpartum copper T 380A insertion with previous regular menstrual cycles for at least 6 months before the current pregnancy, and those who were willing for follow-up visits and had easy accessibility to the hospital, were recruited. A clinical evaluation and ultrasonographic assessment of Intra-Uterine-Contraceptive-Device (IUCD) after insertion was carried out after enrolment. The complications (expulsions, vaginal discharge, menstrual irregularity, and lower abdominal pain) were subsequently assessed during a 6-month follow-up period. The primary objective was the ultrasonographic assessment of the placement of IUCD immediately after insertion. The incidence of complications and their association with the presence of malposition was also studied.
Hundred patients were evaluated during the study period. Forty-four (44 %) women were found to have malpositioned IUCDs on ultrasonographic evaluation done following insertion. The complications among the IUCD users included menstrual irregularity (27.17 %), pain in lower abdomen (20.65 %), vaginal discharge (7.6 %), and expulsions (9.7 %). The IUCD expulsions, menstrual irregularities, and pain were significantly more in patients with malpositions (p < 0.05).
Malpositioning of IUCD is common immediately following insertion and is significantly associated with more complications during the follow-up.
铜T 380A放置不当会导致避孕失败率增加。本研究旨在探寻产后即刻放置的铜T 380A的超声位置与放置后6个月内观察到的不良反应之间的关联。
本描述性研究于2011年9月至2013年2月在印度一家三级医疗中心的妇产科进行。招募了符合产后即刻放置铜T 380A条件的女性，这些女性在本次怀孕前有至少6个月的规律月经周期，且愿意接受随访并方便前往医院。入选后对宫内节育器（IUCD）放置后进行临床评估和超声检查。随后在6个月的随访期内评估并发症（排出、阴道分泌物、月经不规律和下腹痛）。主要目标是放置后即刻对IUCD放置情况进行超声评估。还研究了并发症的发生率及其与位置异常的关联。
研究期间共评估了100名患者。插入后进行超声评估发现，44名（44%）女性的IUCD位置异常。IUCD使用者中的并发症包括月经不规律（27.17%）、下腹痛（20.65%）、阴道分泌物（7.6%）和排出（9.7%）。位置异常的患者中IUCD排出、月经不规律和疼痛明显更多（p<0.05）。
IUCD放置后位置异常很常见，且与随访期间更多并发症显著相关。
