RESUMO
OBJECTIVE: To describe the feasibility of an ultrasound-guided repositioning technique for partially expelled intrauterine devices (IUDs) without use of sedation. METHODS: This was a descriptive feasibility study of patients with a partially expelled IUD managed in our outpatient clinic from January 2016 to February 2020. The partially expelled IUDs (vertical arm extending partially or entirely through the cervical canal) were repositioned at the uterine fundus using Hartmann alligator forceps under ultrasound guidance. Paracervical or intracervical anesthesia and prophylactic antibiotics were not used. Data related to the procedure and 6-month follow-up were extracted from patient medical records. The primary outcome was the success rate of the repositioning procedure, defined as ultrasound confirmation of the entire IUD located above the internal os. Secondary outcomes included the retention and expulsion rates of the repositioned IUD at 6 months after the procedure and description of complications. RESULTS: We included data from 55 women with a partially expelled IUD (35 levonorgestrel IUDs and 20 copper IUDs) referred for repositioning. Ultrasound-guided repositioning of the IUD was successful in 51 (92.7%) cases, while the procedure was not completed in four patients due to pain. Of the 55 procedures, 48 (87.3%) were performed by obstetrics and gynecology trainees under the supervision of a senior specialist. Among the 51 successfully repositioned IUDs, nine (17.6%) were expelled within 6 months after the procedure and six patients were lost to follow-up. No uterine perforation or infection-related complications occurred within 6 months of the procedure. CONCLUSION: The ultrasound-guided repositioning technique appears to be a safe and feasible approach for partially expelled IUDs. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
Assuntos
Dispositivos Intrauterinos , Feminino , Humanos , Gravidez , Estudos de Viabilidade , Ultrassonografia de Intervenção , Útero/diagnóstico por imagemRESUMO
In this study, we examined the physiochemical properties of nasoenteral feeding tubes made from two different types of polymer: silicone materials and polyurethane. The internal surfaces of the nasoenteral feeding tubes were analyzed for their hydrophobicity, roughness, microtopography, rupture-tension and ability to stretch. We also studied the adhesion of an isolated, multi-drug resistant strain of S. aureus to these polymers. The polyurethane nasoenteral tube, which was classified as hydrophilic, was more resistant to rupture-tension and stretching tests than the silicone tube, which was classified as hydrophobic. Additionally, the polyurethane tube had a rougher surface than the silicone tube. Approximately 1.0 log CFU.cm-2 of S. aureus cells adhered to the tubes and this number was not statistically different between the two types of surfaces (p > 0.05). In future studies, new polymers for nasoenteral feeding tubes should be tested for their ability to support bacterial growth. Bacterial adhesion to these polymers can easily be reduced through modification of the polymer's physicochemical surface characteristics.
RESUMO
IN THIS STUDY, WE EXAMINED THE PHYSIOCHEMICAL PROPERTIES OF NASOENTERAL FEEDING TUBES MADE FROM TWO DIFFERENT TYPES OF POLYMER: silicone materials and polyurethane. The internal surfaces of the nasoenteral feeding tubes were analyzed for their hydrophobicity, roughness, microtopography, rupture-tension and ability to stretch. We also studied the adhesion of an isolated, multi-drug resistant strain of S. aureus to these polymers. The polyurethane nasoenteral tube, which was classified as hydrophilic, was more resistant to rupture-tension and stretching tests than the silicone tube, which was classified as hydrophobic. Additionally, the polyurethane tube had a rougher surface than the silicone tube. Approximately 1.0 log CFU.cm(-2) of S. aureus cells adhered to the tubes and this number was not statistically different between the two types of surfaces (p > 0.05). In future studies, new polymers for nasoenteral feeding tubes should be tested for their ability to support bacterial growth. Bacterial adhesion to these polymers can easily be reduced through modification of the polymer's physicochemical surface characteristics.
RESUMO
In this study, we examined the physiochemical properties of nasoenteral feeding tubes made from two different types of polymer: silicone materials and polyurethane. The internal surfaces of the nasoenteral feeding tubes were analyzed for their hydrophobicity, roughness, microtopography, rupture-tension and ability to stretch. We also studied the adhesion of an isolated, multi-drug resistant strain of S. aureus to these polymers. The polyurethane nasoenteral tube, which was classified as hydrophilic, was more resistant to rupture-tension and stretching tests than the silicone tube, which was classified as hydrophobic. Additionally, the polyurethane tube had a rougher surface than the silicone tube. Approximately 1.0 log CFU.cm-2 of S. aureus cells adhered to the tubes and this number was not statistically different between the two types of surfaces (p > 0.05). In future studies, new polymers for nasoenteral feeding tubes should be tested for their ability to support bacterial growth. Bacterial adhesion to these polymers can easily be reduced through modification of the polymer's physicochemical surface characteristics.