ABSTRACT
The cytological modifications due to IUDs are incompletely or inaccurately known to clinicians and cytologists. IUDs of all types bring about a modification of the maturation index, and particularly of the estrogenic index which, throughout the cycle, appears to be lower than that of a control group. The presence of a sub-normal inflammatory contest in smears of IUD users is no proof of an increased incidence of microbic infections. Presently there is no sign of any carcinogenic role played by IUDs. The papillary metaplasia induced by IUDs appeared more frequently than squamous endometrial metaplasia.
Subject(s)
Cervix Uteri/pathology , Endometrium/pathology , Intrauterine Devices/adverse effects , Vaginal Smears , Adult , Female , Humans , Intrauterine Devices, Copper/adverse effects , Metaplasia/pathology , Middle Aged , Uterine Cervical Dysplasia/etiology , Uterine Cervicitis/etiologyABSTRACT
PIP: The author, who helped develop the OMGA IUD in 1966, presents data on the effectiveness and tolerance of the OMGA copper IUD. From July 1980-February 1982, 180 insertions were done, yielding a total of 2302 months of use through May 1982. 26 OOT, 78 OT, 67 IT, and 9 2T devices were included. There were 19 expulsions, 1 removal for metrorragia, 4 pregnancies, 1 ectopic pregnancy, and 1 infection (bilateral salpingitis). Minor problems associated with IUD use were not considered. The Pearl index of 2.08% was higher than that obtained in 1970 with inert OMGA IUDs. The same findings were noted at endometrial biopsies after 1 year of use of OMGA copper devices as had been found with the inert devices. The number of expulsions (10.55% on average for the 4 models) was significant, despite precautions to adjust IUDs to the uterine cavity. The proportion of expulsions varied from 3.84% for the OOT and OT, 16.66% for the IT, to 22.22% for the 2T. In addition, 2 2T IUDs rotated 90 degrees 6 months after insertion, but without requiring removal. No pregnancies occurred with the OOT, 2 with the OT, 1 in a 36-year old women after 15 months and 1 in a 39-year old woman after 7 months; 2 with the IT, 1 in a 36-year old after 7 months and 1 in a 43-year old after 16 months. No uterine pregnancies occurred with the 2T but ectopic pregnancy occurred in a 45-year old woman after 4 months. It is hazardous to predict the in vivo experience of OMGA copper devices based on in vitro experiments, but it appears that after the disappearance of the copper the device becomes an inert OMGA and may be left in place for several years without problems for women over 40.^ieng
Subject(s)
Contraception , Copper , Evaluation Studies as Topic , Intrauterine Devices , Pregnancy , Chemical Phenomena , Chemistry , Contraception Behavior , Family Planning Services , Inorganic Chemicals , Metals , ReproductionABSTRACT
PIP: A total of 10,742 women, 2858 wearing an IUD and 7884 on oral contraceptives (OCs) or not contracepting, were observed to examine the possible cervical and endometrial cytological complications of IUD wearers. The published literature agrees that all types of IUDs bring about a modification of the maturation index, and particularly of the estrogenic index, which appears to be lower than that of a control group. Infection rate for IUD wearers was 5.49%; most infections were of a bacterial origin. The rate for metaplasia was 27.4%, for dysplasia 0.12% at average age 35. Papillary metaplasia seemed to appear more frequently than squamous endometrial metaplasia. Anomalies in the cellular glands were found in 2.41% of cases. In conclusion, there does not seem to be an increased risk of specific infection in IUD wearers; rate of frequency is about identical to that of a control group.^ieng
