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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Silastic implants containing the progestin, levonorgestrel, were tested as long-term contraceptives in 101 women. After three full years of exposure and 2,998 woman-months of use, no pregnancies had occurred. The continuation rates were 87% at 12 months, 79% at 24 months and 66% at 36 months. The most important side effect was excessive or irregular bleeding during the first year. No treatment was offered for this side effect other than vitamins and iron or change of method, with the exception of 3 cases where ethinyl estradiol was used one time for 2 weeks each. Bleeding disturbances led 8 patients to ask for removal of implants. Other side effects were headache, acne and lower abdominal pain. Blood and urine analysis tested 17 different parameters and all but plasma cortisol remained within normal limits throughout the study. A general tendency toward lowered cortisol values was observed and two subjects had more than one value below the normal limit for the population during the study. Glucose tolerance tests during the second year were abnormal in two women with familial diabetes but they returned to normal values spontaneously at the next test. It is concluded that levonorgestrel implants offer effective protection against pregnancy during the first three years of continuous use. Their acceptability and few side effects justify larger trials, especially if treatment of bleeding irregularities is introduced.
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PMID:A three-year clinical trial with levonorgestrel silastic implants. 38 43

Seventy cases of ectopic pregnancy associated with an IUD comprised 10% of all ectopics in a 9 year period. This increased to 15% in the last 19 months as more IUD's were in use. In two thirds of the ectopics the IUD had been in situ more than 1 year. Unusual bleeding and cramping attributed to the IUD obscured the diagnosis and resulted in removal or replacement of the IUD in over one half the cases 1 to 8 weeks before surgery. The episodic nature of the abdominal hemorrhage in two thirds of all ectopics resulted in surgery on day 44 average gestational age. The IUD is probably not causal in ectopic pregnancy but does not protect the predisposed patient from ectopic pregnancy which should be suspected in any patient with an IUD who has irregular bleeding and abdominal pain.
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PMID:Ectopic pregnancy associated with the intrauterine device: a study of seventy cases. 93

A group of 230 women mostly in the 20-30 age range were prescribed the steroid contraceptives Neogest, Norbiogest, Monogest, Non-Ovlon, and Yermonil. 15 women had painful irregular menstruation. 12 women had undergone abortion, and 6 had had a spontaneous miscarriage in the first trimester. Neogest, a one-phase preparation, was used by 28 women. There were 4 cases of menstrual disorders (oligomenorrhea) within 2 years of use and the pills were discontinued. There was 1 case of hypomenorrhea and 1 case of pregnancy with eutocia. Norbiogest, a predominantly gestagen-containing sequential, 2-phase preparation was used by 106 women for 1-10 years. 15 complications occurred (14.1%) consisting of hypo-, oligo-, and amenorrhea, menstrual disorders (2 cases), and lower abdominal pain (6 cases). A liver test was positive in 1 woman who used Norbiogest for 4 years. Monogest, a gestagen preparation for continuous use, was used by 20 women with 4 instances of missed menstruation. 1 case of longer amenorrhea and 1 case of irregular bleeding occurred, manifesting mostly as metrorrhagia. Non-Ovlon, a one-phase preparation, was used by 52 women. After 2 years of use, liver tests became positive. The pill was discontinued, and the tests became negative. Yermonil, a one-phase combined product, was used by 24 women without complications, although 2 women decided to quit using it. There were a total of 25 complications in the sample amounting to 10.8%.
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PMID:[Hormonal contraception and its complications]. 359 92

A comparative study was made regarding the complications of abdominal and vaginal sterilization operations in order to evaluate the efficacy and safety of the 2 procedures. The cases were selected from outpatient departments and family planning clinics of the Patna Medical College (Patna, India) over the 1974-79 period. A preoperative assessment and investigation were performed in all cases. The operations were performed by modified Pomeroy's technique in 300 cases (Group A) by abdominal route and in 300 cases (Group B) by vaginal route. General anesthesia was administered in all cases. Subsequent follow-up was done at intervals of 6 weeks, 3 months, 6 months, 1 year, and up to 5 years. Follow-up attendance was unsatisfactory, but a comparative evaluation of the complications was done in both groups among patients who came for follow-up. Puerperal sterilization cases were excluded from the series. In Group A 149 sterilizations were done with medical termination of pregnancy (MTP) and the remaining were interval sterilizations. In Group B 148 were sterilizations with MTP and the remaining were interval sterilizations. The age varied between 28-42 years. The majority of the patients were more than 4 para in both groups. Pelvic sepsis was more common with vaginal sterilization operations. Complications were as follows in Group A: pyrexia, 30 cases; pain in abdomen, 75; urinary tract infection, 30; sore throat, cough, 60; stitch induration, 90; and wound disruption, 3. For Group B, complications were as follows: pyrexia, 90; pain in abdomen, 30; urinary tract infection, 75; sore throat, cough, 60; tuboovarian mass, 12; wound infection, 45; and persistent temperature rise, 12. The nature of complaints at follow-up for Group A were: leukorrhea, 30; menorrhagia, 60; irregular bleeding, 30; dysmenorrhea, 12; dyspareunia, 9; loss of libido, 9; and incisional hernia, 1. Complaints at follow-up were as follows for Group B: leukorrhea, 45; menorrhagia, 21; irregular bleeding, 60; dysmenorrhea, 75; dyspareunia, 60; loss of libido, 12; abdominal pain, 12; and stress incontinence, 3. In sum, the sterilization operation by abdominal route was much safer compared to the vaginal route.
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PMID:Complications after abdominal and vaginal sterilization operation. 687 69

The incidence of ovarian pregnancies is rare, a ratio of approximately .7 ovarian pregnancies to every 100 ectopic pregnancies. Since 1970, an increasing number of ovarian pregnancies associated with the use of IUDs are reported. A case report of a 34-year old woman, gravida 4, with an IUD in place for 18 months is presented. The patient complained of severe pelvic pain and moderate bleeding 5-6 weeks after her last normal menstrual period. Tissue, grossly ressembling placental tissue was passed, after which the pain stopped and the bleeding became minimal. On recurrence of pain and heavier bleeding, the patient underwent a dilatation and curretage and removal of the IUD, but the pain persisted. Ultrasound revealed a normal uterus and a left adnexal mass. Exploratory laparotomy to correct what was thought to be a hemorrhagic corpeus luteum cyst, resulted in a left oophorectomy. The pathology report showed an apparent gestational sac and a 10 mm embryo. In an analysis of 33 cases of ovarian pregnancy, another author noted the presence of vaginal bleeding, abdominal pain, uterine enlargement, and adnexal masses in a majority of cases on which the data were collected. Although the IUD has been shown to reduce the incidence of uterine implantation by 99.5% and tubal implantation by 95%, it does not reduce the incidence of ovarian pregnancy. Incidence of ovarian pregnancy among IUD users is thought to be 1 for every 7-9 ectopic pregnancies, in the general population, the incidence is 1 to every 150-200 ectopic pregnancies. This is probably due to the local enzyme or chemical action on the endometrial cavity and tubes. This apparent increase in ectopic pregnancies seems to be relevant only to the number of intrauterine pregnancies prevented by the IUD. Patients with IUDs, presenting with positive pregnancy tests, irregular bleeding and abdominal pain should be evaluated by ultrasound.
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PMID:Ovarian pregnancy associated with a copper-7 intrauterine device: report of a case and review of the literature. 711 13

During 13 months from November 1, 1977, through November 30, 1978, 283 patients underwent radioimmunoassay (RIA) for determination of serum beta-subunit of human chorionic gonadotropin (beta-hCG) to rule out ectopic pregnancy. The records of 234 patients were available for statistical analysis and of these, 188 (80%) had negative results, defined as less than 1 ng/ml. The ectopic group comprised 22 patients, all of whom had elevated beta-hCG levels. There were no false-negative results in either group. Patients with suspected ectopic pregnancy had symptoms similar to patients previously reported in the literature with proved ectopic pregnancies. The most common presenting symptoms of those with suspected ectopic pregnancy were abdominal pain (91%), amenorrhea (76%), irregular bleeding (68%), and andexal mass (55%). Seventy-three patients presented with the classic triad of pain, uterine bleeding, and adnexal mass. Only 10 (14%) had ectopic pregnancies. Urine pregnancy tests were found to be of no benefit in diagnosing ectopic pregnancy and confused the clinicians in some instances. In patients with suspected ectopic pregnancy, a negative beta-hCG, by the RIA technique ruled out ectopic pregnancy in 100% of the cases.
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PMID:beta-hCG as a diagnostic aid for suspected ectopic pregnancy. 739 9

The aim of the study was to determine the presenting symptoms of endometrial carcinoma (EC) patients and to assess their possible correlation with some of the standard prognostic factors and with survival. A review of the presenting symptoms of 181 EC patients indicated that 69.6% presented with postmenopausal bleeding while the remaining women presented with irregular bleeding (21.0%), abdominal pain (3.9%) and other (5.5%) symptoms. A significantly (p < 0.001) higher percentage of patients presenting with abdominal pain and other symptoms were diagnosed with advanced stage disease and they had a lower survival than those presenting with post-menopausal or irregular bleeding. Patients presenting with irregular bleeding had a significantly (p = 0.002) better survival than those presenting with postmenopausal bleeding. However, this effect disappeared once age was accounted for in a multivariate analysis. Our findings indicate that the type of presenting symptoms may occasionally serve as a preliminary prognostic indicator.
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PMID:Presenting symptoms of patients with endometrial carcinoma. Effect on prognosis. 875 May 11

At the Institute for Reproduction in Bombay, India, 1339 IUD insertions were performed in the 6 years from 1965 to 1970. 49 pregnancies with the IUD in place resulted, which equals a 3.6% failure rate. 92% of these pregnancies occurred within 2 years of insertion. A high percentage of abortion occurred with these pregnancies. In 5 cases of full term delivery and 1 of abortion, the IUD remained in the uterus. The attending doctor must be sure the IUD has been expelled. Ectopic pregnancy is possible with an IUD; this possibility must be ruled out whenever there is any case of irregular bleeding or abdominal pain.
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PMID:Pregnancies and intrauterine devices with special reference to the outcome of pregnancies and the fate of the devices. 1225 37

Injectable progestogen, norethisterone enanthate (NET-EN, 200 mg/ml) was administered to 122 women at 2 month intervals for more than 1 year. Only a minority of women had consistently normal cycles. Most women experienced some menstrual irregularities: 57% of users experienced irregular bleeding, 32% developed amenorrhea, while only 11% showed regular cyclic bleeding. Important nonmenstrual side effects were weakness and abdominal pain. No appreciable changes in body weight and blood pressure were recorded.
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PMID:Clinical trial of a long-acting injectable contraceptive: NET-EN. 1231 44

Pouch of Douglas aspirates were collected from 50 women with history and examination suggestive of acute pelvic inflammatory disease (PID) and 20 healthy women admitted for tubal ligation served as control. A total of 57 microorganisms were isolated from 37 patients out of 50 in study group. Of 37 positive cultures 21(56.7%) were monomicrobial and 16(43.2%) were polymicrobial. Most common symptom in study group was lower abdominal pain (90%), vaginal discharge (70%) and irregular bleeding (40%) and 30% patients had history of intrauterine contraceptive device (IUCD) implantation. The predominant aerobic isolates were Escherichia coli, Coagulase Negative Staphylococcus (CONS), Staphylococcus aureus, Klebsiella pneumoniae while common anaerobes were Bacteroides fragilis, Prevotella melaninogenica, Fusobacterium nucleatum and Peptostreptococcus spp. Our study shows that cefotaxime, cefuroxime and gentamicin may be used for gram negative aerobic bacilli; cloxacillin, cephaloridine and erythromycin for aerobic gram positive cocci and amikacin and ceftazidime for Pseudomonas aeruginosa. Thus for optimum therapy of acute PID it is beneficial to keep in mind major conceptual changes and therapeutic realities that have influenced current understanding of acute PID and have affected the choice of therapy.
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PMID:Role of anaerobes in acute pelvic inflammatory disease. 1764 17


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