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Objective To compare the effectiveness of medicated γintrauterine device (IUD) and medicated genefix IUD inserted immediately after abortion. Methods A multicenter clinical trail was performed for the study from Mar. 2012 to Jan. 2013. Totally 840 women who volunteered to participate were randomly allocated to γ-group (medicated γ IUD) or genefix-group (medicated genefix IUD) immediately after abortion. While 464 abortion women who had not used IUD or steroids contraceptive methods were chosen as control group. The effectiveness of the IUD were followed up for 1 year. All women were required to record the number of vaginal bleeding days and blood volume of vaginal bleeding within 3 months after abortion. Results At the 12th month, the expulsion was the most common reason for termination. The expulsion rates of genefix-group and γ-group were 2.48/100 women years and 3.12/100 women years, respectively (P>0.05). For the expulsion reasons, IUD moving down could account for more than seventy percent. The removal rate for IUD usage of two IUD groups were almost equal (3.91/100 women years verus 4.35/100 women years), the differences were not statistically significant (P>0.05). At the 90th day after abortion, comparing with control group, the bleeding and (or) spotting days of genefix-group and γ-group extended by 3.9 and 2.6 days respectively, the differences had statistical significance between the three groups (P0.05). Conclusion The insertion of medicated genefix IUD and medicated γ IUD immediately after abortion is safe, feasible, has slight side effects and could be effective contraception.
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Objective Through analysed the questionnaire about postpartum contraception knowledge-attitude-practice (KAP) among obstetricians,to understand the postpartum contraceptive knowledge,idea,attitude and related factors among obstetricians.Methods From October 2013 toDecember 2013,209 obstetricians of 10 different levels of the hospital of Tianjin area had been enrolled in this study,and KAP questionnaire was investigated.Results The knowledge of postpartum contraception among obstetricians was seriously lack,the total correct rate was 34.8％,the lowest score was 5 points,the highest was 80 points,the average score was 34.8± 13.5,more than 60 points accounted for only 2.9％ (6/209).86.6％ (181/209) obstetricians have thought it necessary to carry out postpartum contraceptive propaganda during pregnancy,and 97.6％ (204/209) obstetricians have thought it necessary to develop postpartum contraception training.92.8％ (194/209) and 94.2％ (197/209) obstetricians always informed that pay attention to contraception before discharge and postpartum visit,specific methods were not discussed.Obstetricians obtained relevant progress of contraceptive knowledge mainly through the daily medical work (92.8％,194/209),hoped that approach postpartum contraception related knowlege through continuing education courses (77.5％,162/209),special lectures in academic conference (72.2％,151/209) and special training (67.5％,141/209).Conclusions (1) The postpartum contraception knowledge among obstetricians is seriously lack.(2) The obstetricians hold positive attitude towards the propaganda for postpartum contraceptive knowledge.(3) Postpartum contraception related education only provided before discharging and postpartum visit,and the content was simply inform that pay attention to contraception,specific methods are not discussed.(4) To explore the reason why postpartum contraception situation is not ideal,that's because insufficient attention and propaganda,obstetricians don't update the contraception knowledge,and be lack of knowledge on the efficient,long-acting reversible contraception methods,exaggerated the side effects and complications.
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Objective To compare efficacy of female sterilization by modified Uchida technique and silver clips and to evaluate the influence on operation procedure and clinical effect with or without surgery training of service providers. Methods A comparative, multicenter clinical trial was performed in 18 county and township-level service centers. Totally 2198 women underwent sterilization from these 18 study center were divided into 1116 women sterilized by modified Uchida technique and 1082 women by silver clips.Those 18 centers were classified into 9 training groups which provide surgical skills of sterilization and other contents and 9 non training groups. Clinical documents of sterilization were recorded. All women were followup at 3, 6 and 12 months after surgery. Results There were no complications during surgery by both sterilization. The failure rate was 2.03% (22/1082) in silver clip method and the mean operative time were ( 12. 4 ± 6. 4 ) minutes in training group and ( 14. 4 ± 8. 1 ) minutes in non training group. In modified Uchida method, the failure rate was 0. 18% (2/1116) and the mean operative time were (16. 2 ± 4. 9)minutes in training group and (19.0 ±8.6) minutes in non training group. The mean operative time between two groups reached statistical difference ( all P ＜ 0. 05 ). Total ended rate in modified Uchida technique were 2. 2/hundred women year in training group and 2. 5/hundred women year in non training group, and the rate of silver slips were 3. 9/hundred women year and 4. 8/hundred women year, which did not show significant difference ( all P ＞ 0. 05 ). There was no significant difference in acceptability and side effects of all women between two methods (P ＞ 0. 05). The training of service providers could influence acceptability of women (P ＜ 0. 05). Conclusions Clinical efficacy was not influenced by those two methods. The operative time and acceptability were improved by training surgeons in silver clips method.
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In gynecology, it is very important to obtain the parameters of women's uterine musculature, such as its deformation size and contraction frequency, etc. This paper proposes a type of sensor for measuring these parameters and also analyzes its force situation. The sensor is flexible, deformable, and can adjust itself to the shape of the uterus. It can be put into the women's uterine cavity easily. The experiment shows that the sensitivity of the left and right sets coils of the sample sensor achieves 22.38 nH/mm2, while that of the top set coils achieves 22.84 nH/mm2, and the reaction time of the sensor is less than 200 ms. These results can meet the requirements of sensitivity and reaction time for testing the contraction situation of uterine musculature. The sensor has been applied in some medical fields.
Subject(s)
Female , Humans , Biosensing Techniques , Equipment Design , Intrauterine Devices , Micro-Electrical-Mechanical Systems , Uterine Contraction , PhysiologyABSTRACT
AIM: The development of the 'frameless' intrauterine system (IUS) is a response to the growing need to develop high-performing, long-acting, reversible, and acceptable contraceptives with a high continuation of use. METHODS: This is a review of 15 years of clinical experience in randomized controlled and non-randomized clinical trials. RESULTS: The IUS has a similar failure rate as the TCu380A Intrauterine device (IUD), considered the 'golden standard' IUD, which is attributed to the optimal target delivery of the copper ions in the upper part of the uterine cavity. Its performance is further optimized by the atraumatic design, which reduces partial and total expulsion and minimizes the side-effects and discomforts experienced with conventional 'framed' IUDs. The mini IUS is likely to further reduce the menstrual blood loss due to the very small size. The safety of the anchoring concept is beyond doubt as was demonstrated in all clinical studies covering 15,000 woman-years experience. CONCLUSIONS: Young nulliparous/nulligravid and parous women may significantly benefit from the advantages the 'frameless' IUS, which could be strategically important to help in reducing the increasing number of unintended pregnancies and induced abortions worldwide. Furthermore, the 'frameless' IUS has been shown to be highly effective for emergency contraception and for immediate postabortal insertion. The long lifespan of the IUS could constitute a cost-effective reversible alternative to irreversible female sterilization.
