Ectopic pregnancies associated with low dose progestagen-releasing IUDs

Dfaz, S.; Pavéz, Margarita; Quinteros, Eliana; Carrillo, Daniel de la Rosa; Simonetti, Luis; Croxatto, H; Rosati, Silvia

doi:10.1016/s0010-7824(80)80005-9

Cited by 8 publications

(9 citation statements)

References 13 publications

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“…However, Ory [4] demonstrated that the use of IUCD could not explain the rising incidence of ectopic pregnancies in the United States. Snowden [5] and Diaz et al [6] found a definite increase in the incidence of ectopic pregnancy with the inert IUCD to which progestogen had been added. The reason for this increase is not yet clear.…”

Section: Ectopic Pregnancy In King Fahad Hofuf Hospital: a Five Year mentioning

confidence: 99%

Ectopic Pregnancy in King Fahad Hofuf Hospital: A Five Year Experience

1992

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Out of a total of 45,836 deliveries over a five-year period (1986)(1987)(1988)(1989)(1990), 128 cases of ectopic pregnancy (0.28% incidence) managed during this period was compared with other previously published data in terms of presentation and management. There were no maternal deaths among the cases treated. The age distribution was 16-44 years with higher incidence 46 (36%) occurring in the range of 25-30. One hundred thirty (93%) were multipara. The presenting complaints included pain (100%), vaginal bleeding (78.4%) and amenorrhea (39.8%). The most consistent clinical finding was cervical excitation tenderness (88%). Ultrasonography (88%) and laparoscopy (50%) were adjunctive only to history and physical examination which was found to be most important in the diagnosis. Detection of an adnexal mass separate from the ovaries with or without hemoperitoneum was diagnostic of ectopic pregnancy. One hundred two (79.6%) diagnosed as rupture, 17 (13%) as aborted and five (3.9%) as intact. With the changing picture of ectopic pregnancy, one case each was initially diagnosed as appendicitis, urinary tract infection and anemia and admitted in the medical ward before further review confirmed the diagnosis of ectopic pregnancy. The sites of implantation included 123 in ampulla (96%), one each in ovary, cornual and cervix with two diagnosed as having abdominal pregnancy. The predisposing factors include pelvic inflammatory disease (22.6%), previous ectopic (10.2%) and recent IUCD (9%), but none insitu at the time of ectopic. Our treatment of choice is salpingectomy but 12% had salpingo-oophorectomy for various reasons, while total abdominal hysterectomy was performed for the cervical pregnancy for uncontrollable hemorrhage. BN Ogbonna, A Al-Nemr, M Moghanam, Ectopic Pregnancy in King Fahad Hofuf Hospital: A Five Year Experience. 1992; 12(6): 544-547 A total of 128 cases of ectopic pregnancy were treated over a five year period in King Fahad Hofuf Hospital. The total number of deliveries during this period was 45,836 and the incidence of ectopic pregnancy in the area was 0.28% (2.8/1000 births). No maternal deaths occurred among the cases diagnosed and treated in the hospital during the five years. King Fahad Hospital is the only tertiary center in Al-Hassa and therefore serves a population of approximately 600,000. The aim of this study was to analyze the clinical features, and diagnosis and treatment of all cases encountered in Al-Hassa and comparison, where necessary, of our results with previously published data. Patients and ResultsThe hospital charts of all the patients who were admitted with or diagnosed to have ectopic pregnancy between 15 September 1986 and 22 July 1990G (1 Muharram 1406 and 30 Dhu Al-Hijjah 1410H) were retrieved and reviewed. The relevant information collected from the charts included nationality, parity, age, clinical presentation, treatment, and subsequent follow-up. The anatomical description of the site of implantation was also obtained from During 15 September 1986 and 22 July 1990, ...

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Section: Ectopic Pregnancy In King Fahad Hofuf Hospital: a Five Year mentioning

confidence: 99%

Ectopic Pregnancy in King Fahad Hofuf Hospital: A Five Year Experience

1992

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“…Nineteen studies limited recruitment to women with proven fertility. 43,47,73,85,[98][99][100][101]105,106,108,110,114,[117][118][119][120]122,125 Five studies recruited women immediately after giving birth or after abortion. 100,106,110,118,119 One of these studies restricted recruitment to women who were breastfeeding.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…110 Six studies (20%) stated that they only included women with a regular menstrual cycle. 87,98,115,[120][121][122] Nearly all of the studies, for both the RCTs and the non-randomised prospective cohorts, were either comparisons of IUSs with different hormonal dosage release rates or of IUSs versus non-hormonal IUDs. The two exceptions were studies by Wang and colleagues 47 who compared the LNG-20 IUS with Norplant-2, and Sivin and colleagues 72 who investigated return to fertility after discontinuation of subdermal implants, IUSs or IUDs.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Fourteen studies provided information on the date of device insertion and all devices were inserted within appropriate time frames. 43,47,73,98,101,106,110,111,114,[118][119][120]123,125 Excluded studies…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…In five of the ten non-RCTs 72,[120][121][122]125 included in the review, it was clear that the comparative groups had been treated in the same way in terms of investigations and follow-up visits. None of the studies reported that the investigators were blinded to contraceptive method when assessing outcomes.…”

Section: Non-randomised Prospective Cohort Studiesmentioning

confidence: 99%

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Implantable contraceptives (subdermal implants and hormonally impregnated intrauterine systems) versus other forms of reversible contraceptives: two systematic reviews to assess relative effectiveness, acceptability, tolerability and cost-effectiveness.

French

Cowan²,

Mansour³

et al. 2000

Health Technology Assessment

109

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et al. Implantable contraceptives (subdermal implants and hormonally impregnated intrauterine systems) versus other forms of reversible contraceptives: two systematic reviews to assess relative effectiveness, acceptability, tolerability and cost-effectiveness. Health Technol Assess 2000;4(7). Health Technology Assessment is indexed in Index Medicus/MEDLINE and Excerpta Medica/ EMBASE. Copies of the Executive Summaries are available from the NCCHTA website (see overleaf). NHS R&D HTA Programme T he overall aim of the NHS R&D Health Technology Assessment (HTA) programme is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and work in the NHS. Research is undertaken in those areas where the evidence will lead to the greatest benefits to patients, either through improved patient outcomes or the most efficient use of NHS resources. The Standing Group on Health Technology advises on national priorities for health technology assessment. Six advisory panels assist the Standing Group in identifying and prioritising projects. These priorities are then considered by the HTA Commissioning Board supported by the National Coordinating Centre for HTA (NCCHTA). This report is one of a series covering acute care, diagnostics and imaging, methodology, pharmaceuticals, population screening, and primary and community care. It was identified as a priority by the Pharmaceutical Panel and funded as project number 95/41/01. The views expressed in this publication are those of the authors and not necessarily those of the Standing Group, the Commissioning Board, the Panel members or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for the recommendations for policy contained herein. In particular, policy options in the area of screening will be considered by the National Screening Committee. This Committee, chaired by the Chief Medical Officer, will take into account the views expressed here, further available evidence and other relevant considerations. Reviews in Health Technology Assessment are termed 'systematic' when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. Criteria for inclusion in the HTA monograph series Reports are published in the HTA monograph series if (1) they have resulted from work either prioritised by the Standing Group on Health Technology, or otherwise commissioned for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors.

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IUD complications

Simcock¹

1985

Biomedical Aspects of IUDs

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Ectopic pregnancies associated with low dose progestagen-releasing IUDs

Cited by 8 publications

References 13 publications

Ectopic Pregnancy in King Fahad Hofuf Hospital: A Five Year Experience

Ectopic Pregnancy in King Fahad Hofuf Hospital: A Five Year Experience

Implantable contraceptives (subdermal implants and hormonally impregnated intrauterine systems) versus other forms of reversible contraceptives: two systematic reviews to assess relative effectiveness, acceptability, tolerability and cost-effectiveness.

IUD complications

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