Intrauterine device and maternal copper metabolism during lactation☆

Cunha, Antônio Carlos Rodrigues da; Dórea, José G.; Cantuaria, A. A.

doi:10.1016/s0010-7824(00)00191-8

Cited by 15 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3,4 PPIUCD overcomes the pain and anxiety of procedure as compared to the interval insertion. It is a good method of spacing and also beneficial for the females who don't ABSTRACT Background: The present study evaluates safety, efficacy, expulsion rate and complications of PPIUCD insertion in women undergoing caesarean section in a medical college for 2 years period.…”

Section: Introductionmentioning

confidence: 99%

Two years follow up study of post placental insertion of IUCD during caesarean sections: safety, efficacy and complications

Pandher

Rani

Goel

2018

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

INTRODUCTIONGlobally, intrauterine devices (IUDs) are cited as the second most widely used contraceptive method according to a WHO study. 1 The IUD recommended by WHO is CuT380A which got USFDA approval in 1984.Post placental insertion of IUCD (PPIUCD) has been recommended by WHO to be safe, effective, reversible and immediate method of contraception. This is the time when parturient is highly motivated for effective contraception. In developing country like India where women are still not fortunate enough to get medical services easily, this is the time when most of them come in contact with the trained medical personnel.Various studies have proved safety of IUCD when inserted post-placentally. It has good acceptability because of the safety and being reversible.2 WHO has approved IUCD use even in breast-feeding women since it has no effect on lactation, not even in terms of any increased copper in milk. 3,4 PPIUCD overcomes the pain and anxiety of procedure as compared to the interval insertion. It is a good method of spacing and also beneficial for the females who don't ABSTRACT Background: The present study evaluates safety, efficacy, expulsion rate and complications of PPIUCD insertion in women undergoing caesarean section in a medical college for 2 years period. Methods: This is a prospective cohort study done over a 2 year period. Total 185 patients undergoing caesarean section and fulfilling medical eligibility criteria for PPIUCD were enrolled in the study. The followup of these patients was done at 6 weeks, 6 months and 1-2 years. Results: Thirteen patients (7%) lost to follow up so final outcome analysis was done in 172 patients. The problems encountered were spontaneous expulsion in 4 patients, removal due to heavy menstrual flow in 13 patients, nonvisibility of threads in 4 patients, discharge per-vaginum in 1 patient and pain lower abdomen in 1 patient. Voluntary removal was done in 3 patients by 2 years who wished to conceive. The successful continuation rate came out to be 84.9% by 2 years. There was no failure reported in terms of intra-uterine or extra-uterine pregnancy and no increased risk of infection or perforation over the 2 years follow up. Conclusions: Immediate post-placental IUCD insertion is safe and effective method of contraception with no need to wait for 6 weeks which thereby reduces unwanted pregnancy rates. Mild discomfort and the minor post procedure complaints are taken care of well in puerperium. Higher rate of expulsion can be taken care of by early follow-up with regular visits and offering other safe and effective method of contraception.

show abstract

Section: Introductionmentioning

confidence: 99%

Two years follow up study of post placental insertion of IUCD during caesarean sections: safety, efficacy and complications

Pandher

Rani

Goel

2018

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…It should not be expected to have an effect on lactation (either positive or negative). Studies of lactation in women using the IUD confirm this 33,35–45…”

Section: The Effect Of Iuds On Lactationmentioning

confidence: 78%

Intrauterine contraception after cesarean section and during lactation: a systematic review

Goldstuck¹,

Steyn²

2013

IJWH

View full text Add to dashboard Cite

BackgroundAll postpartum women, including those who are breastfeeding or have had a cesarean section, appear potentially suited to intrauterine contraception, a long acting reversible contraceptive (LARC). Like any other method used after delivery, it should not interfere with lactation or be affected by cesarean section.Study designWe searched the MEDLINE, PubMed, Popline, Google Scholar, and Clinicaltrials.gov databases from January 1968 through to December 2012. Studies were included if they reported event rates in women who had a cesarean section and event rates and clinical outcomes in lactating women or their infants in the breastfeeding group. Summary odds ratios were not calculated because of the diverse methods of reporting event rates in the cesarean section group and the heterogeneity of the results in the breastfeeding group.ResultsWe found 26 articles on event rates in interval and post-placental intrauterine device (IUD) use, and 18 on event rates and clinical outcomes in breastfeeding IUD users. Four prospective studies and one retrospective study showed an increased expulsion rate in interval insertion. There were 19 studies, of which five were controlled in post-placental IUD insertion after cesarean section. Four studies had expulsion rates of 10 or more per 100 woman-years of use and 15 expulsion rates below 10 per 100 woman-years of use. Three studies showed that event rates for lactating IUD users are the same as those for non-lactating users. Fifteen controlled studies showed that the IUD had no effect on milk production and seven of these showed no effect on infant growth. Pharmacovigilance databases report an increased rate of IUD perforations in lactating women, while the event rate studies report that insertion is generally easier and less painful than expected. These were uncontrolled reports.ConclusionThe IUD is a long-acting reversible method of contraception with expulsion rates of 5–15 per 100 woman-years of use when used as a post-placental method immediately after cesarean section. As an interval procedure (6 or more weeks after cesarean section) it appears to have a high expulsion rate (5% or higher) notably in older devices. The IUD does not affect breastfeeding and is easy to insert in these women, but appears to be associated with a higher perforation rate (>1 per 100). Providers should not be deterred from using this contraception method, especially in developing countries, but should be attentive to preventing these potential problems.

show abstract

“…The ample use of copper containing intrauterine devices among female participants is a limitation to the study; it was not possible to obtain volunteers that did not use them, but their frequency of use in the two groups of women was similar. Decision to accept women with IUDs was based on evidence that show that oral contraceptives increase serum copper concentrations and estrogens/progesterone [41], but intrauterine devices do not [42]. It has been reported that activities of liver aminotransferases in the general population depend on lifestyles [43] and that the three enzyme activities routinely measured as indicators of liver function may differ in population subgroups depending on variables, such as age, body mass index, presence of diabetes 1, and other conditions [43,44].…”

Section: Discussionmentioning

confidence: 99%

Influence of Estrogens on Copper Indicators: In Vivo and In Vitro Studies

Arredondo

Núñez

López

et al. 2009

Biol Trace Elem Res

View full text Add to dashboard Cite

Classic copper indicators are not sensitive and specific for detecting excess copper exposure when this is higher than customary but not markedly elevated. Serum copper and ceruloplasmin (Cp) are the most commonly used indicators to assess nutritional status of copper. The objective of this paper was to study the influence of estrogens on these indicators and others used to assess early effects of excess copper exposure in humans and the expression of a set of copper related proteins in a hepatic cellular model. For the studies in humans, 107 healthy participants (18-50 years) were allocated as follows: group 1 (n = 39), women assessed on day 7 of their hormonal cycle; group 2 (n = 34), women assessed on day 21 of their hormonal cycle, and group 3 (n = 34, comparison group), healthy men. Participants received 8 mg Cu/day (as copper sulfate) during 6 months. Serum Cp and Cu, Cu-Zn-superoxide dismutase activity, liver function indicators [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyltransferase (GGT)], and serum Fe and Zn concentrations were measured monthly. In addition, the influence of estradiol on intracellular total copper content, hctr1, dmt1 and shbg mRNA abundance and hCTR1, and DMT1 expression was measured in HepG2 cells. Serum Cu, Fe, and Zn and liver aminotransferases but not Cu-Zn-superoxide dismutase varied depending on sex. Fe nutrition indicators, GGT, and ALT activities showed significant differences between the hormonal phases. Cellular experiments showed that estradiol increased cellular Cu concentration and hCTR1 and DMT1 mRNA expression and changed these proteins expression patterns. Estradiols significantly influence the responses to copper at the whole body and the cellular levels, suggesting that they help maintaining copper availability for metabolic needs.

show abstract

Intrauterine device and maternal copper metabolism during lactation☆

Cited by 15 publications

References 14 publications

Two years follow up study of post placental insertion of IUCD during caesarean sections: safety, efficacy and complications

Two years follow up study of post placental insertion of IUCD during caesarean sections: safety, efficacy and complications

Intrauterine contraception after cesarean section and during lactation: a systematic review

Influence of Estrogens on Copper Indicators: In Vivo and In Vitro Studies

Contact Info

Product

Resources

About