[Ectopic pregnancy in women using the IUD (report of a case)]. / A proposito di gravidanza ectopica in protatrice di IUD (Presentazione di un caso)

PIP: With a Pearl index of 2.0-2.6, IUDs are used by about 15 million women around the world, or about 7.4% of married women. The mode of action of IUDs is still not completely clear; it is probable that the device inhibits implantation and impairs spermatozoa motility. The article reports on the case of a young multipara, wearer of a copper IUD for 5 years, hospitalized for bleeding and severe pain. Laparotomy revealed tubal pregnancy and a ruptured right tube. The patient left the hospital in very good condition 10 days after the operation. While the incidence of uterine pregnancy in IUD wearers is reputed to be 1.76%, the incidence of ectopic pregnancy goes from 2.5% to 9.85%, according to different authors, or a risk 10 times higher than that of nonwearers. Whether the device itself is the cause of the ectopic pregnancy is still debated. It is possible that the inflammatory action caused by the IUD at the endometrial level, and which inhibits implantation, is not so great at the level of the tubes, thus allowing an ectopic pregnancy.^ieng

[Morphological changes of the endometrium and ovary (optical and electronic microscopic observations) and their functional reversibility after prolonged use of synthetic estroprogestogens]. / Alterazioni morfologiche dell'endometrio e dell'ovaio (osservazioni al microscopio ottico ed elettronico) e loro reversibilità funzionale dopo uso prolungato di estroprogestinici di sintesi.

PIP: This study reports on the case of a 32-year-old patient who had been on OCs (oral contraceptives) for only 12 months, who was hospitalized for adnexial tumefaction. Am ovarian biopsy was done by observing with the optic and with the electronic microscope the modifications caused by the treatment on the ovary and on the endometrium. The observations revealed such serious pathological and degenerative modifications that the patient was recalled after 7 years to conduct the same kind of observations. On that occasion it was established that the patient, who has stopped hormonal contraceptive use, had resumed normal ovulatory capacity, and that hypophysary and ovaric secretions were absolutely normal. It is doubtful whether a longer period of OC use would allow the ovary to retain its ability to resume complete regular functions.^ieng