ABSTRACT
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.
Subject(s)
Foreign-Body Migration/diagnosis , Foreign-Body Migration/etiology , Intrauterine Device Expulsion/adverse effects , Uterine Perforation/diagnosis , Uterine Perforation/etiology , Adult , Female , Foreign-Body Migration/surgery , Humans , Pelvic Inflammatory Disease/etiology , Risk Factors , Uterine Hemorrhage/etiology , Uterine Perforation/surgery , Young AdultABSTRACT
UNLABELLED: The objective of the study was to determine changeableness of blood cells count, hemoglobin (HGB) and hematocrit (HCT) within the peripheral blood of patients who received betamethasone during treatment of threatened preterm delivery. 65 patients at increased risk of preterm delivery received intramuscular injections of betamethasone 3 x 4 mg/day for fetal lung maturity and to decrease the risk of CNS trauma in newborns. RBC, HGB, HCT, WBC, neutrophils count and CRP level were measured before treatment and on the 1th, 2nd and 7th days after first dose of betamethasone. The steroid administration caused a significant decrease in RBC, HGB and HCT: The lowest levels were noticed on 2nd day. Statistically significant changes were observed between before and 1st day (p < 0.0001), before and 2nd day (p < 0.0001), before and Ist week (p < 0.05), 1st day and 1st week (p < 0.006), 2nd day and Ist week (p < 0.005). The level of WBC and neutrophils were increased. Their peak levels were noticed on 1st day. Statistically significant changes were observed between before and 1st day (p < 0.0001), before and 1st week (p < 0.0003), 1st day and 1st week (p < 0.0001), 2nd day and 1st week (p< 0.001). After 3 days there was a significant decrease of WBC and neutrophils count. CONCLUSIONS: Intramuscular administration of 12 mg betamethasone per day caused decrease of the RBC, HGB and HCT account and elevation of the WBC and neutrophil count. All these parameters normalized after about 7 days.
