Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001577 (adnexitis)
 232 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 2 case reports the radiologic diagnosis of pelvic abscess caused by a Dalkon Shield type IUD was demonstrated. In the 1st case the pelvic abscess was visualized as an impression on the anterior rectal wall and the displacement of the distal 1/3 of the sigmoid. This was confirmed at laparotomy when a Douglas abscess and an inflamed uterus was found. In the 2nd case a segmental narrowing of the rectum and distal 1/3 displacement of the sigmoid were radiographically demonstrated. The spontaneously draining sacrouterine abscess healed with conservative treatment. The Dalkon Shields were removed in both cases. Although the newer IUD's carry less risk of infection this risk is still considerable as reported in the literature. A 1978 review of 6 epidemiologic studies points to a 3 to 5-fold higher risk of pelvic infection with IUD use. This risk may be higher for women without previous pregnancy and may drop to a low of 1.7 in women with previous pregnancy. Some authors point to a higher risk of adnexitis with the Dalkon Shield compared to other types of IUDs. The Dalkon Shield has been removed from the market in the US and other countries after a US publication of 35 fatalities caused by sepsis in IUD users.
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PMID:[Radiologic demonstration of pelvic abscess associated with I.U.D. (Dalkon Shield) in two patients (author's transl)]. 732 15

The history, current status, indications and contraindications for intrauterine contraception are described, information on safety and side effects is cited from the literature, and the experience of 1 clinic with IUDs is discussed. In 1976, 200,000 women in the German Democratic Republic used IUDs, or 50/1000 women aged 15-45. Intrauterine contraception had a slower and less steady development than oral contraception. The most widely used 2nd generation IUDs in East Germany were manufactured of plastic in the USSR, while the DANA copper and copper-T are the most widely used 3rd generation devices. The last days of the menstrual period are the best times for insertion, but placement immediately following abortion or birth is also possible. IUDs are indicated in cases where hormonal contraception is contraindicated. Contraindications to IUD use include suspicion of pregnancy, genital infection, atypical cytological finding, serious menstrual disturbances or bleeding of unknown cause, myomatous uterus, genital neoplasia, and deformation of the cervix or uterine cavity. The most significant complications and side effects of IUD use are bleeding disorders, dysmenorrhea, expulsion of the IUD, inflammation of the pelvic organs, undesired pregnancy, extrauterine pregnancy, and perforation of the uterus. Data from a gynecological clinic serving a predominantly rural area on 121 patients who used IUDs for a variety of reasons between June 1975 and August 1980 are presented. Observations covered a total of 4309 cycles and averaged 35.6 cycles per woman. Average age of patients was 31.7 years, no insertions were done in nulliparous patients, and the longest user had an IUD in place for 94 months. 29 patients had DANA superlux, 61 had DANA cor, 10 had DANA copper, and 21 had copper T devices. Complications and side effects were observed in 32 cases, including 19 cases of bleeding problems, of which 6 required removal; 5 of pregnancy, all of which were ended by abortions and which imply a Pearl Index of 1.4 pregnancies/100 woman years; 2 cases of adnexitis; and 2 cases of expulsion. 18 IUDs were removed, including 6 because of bleeding, 5 for pregnancy, 2 spontaneously expelled, 2 during hysterectomies, 2 because of desire for pregnancy, and 1 because of menopause.
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PMID:[Intrauterine contraception from the viewpoint of an ambulatory gynecologic department]. 734 87

The author presents a list of do's and do not's to be observed in the case of before metropathia following induced abortion. For the diagnostic, the doctor should conduct an in depth interrogatory concerning the details of the operation and of the symptoms. A complete examination must be performed. The doctor should not perform a new curettage automatically nor prescribe antibiotics without having carefully examined the patient. He should also watch for the possibility of GEU. As a preventive action, the doctor should work with utero-tonics, check the uterine cavity, eliminate the possibility of GEU, examine the ovular remains and see the patient again within 10 days for a check-up. He should not consider induced abortion as a minor operation. As a treatment, the doctor should perform a laparoscopy in the case of a doubt; in the case of fever, pain, metrorrhagia and soft, tender uterus, he should prescribe an antibiotherapy plus a control curettage. In the case of fever with pain, metrorrhagia, painful cul-de-sac and well retracted uterus, he should perform NFS, VS, ECBU and laparoscopy if there is a possibility of adnexitis. He should not send the patient home without having made sure of the absence of the above mentioned complications.
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PMID:[Before metropathia caused by induced abortion: the do's and do not's]. 1233 6


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