World Health Organization : Technical Report Series, No. 397: Intra-Uterine Devices ; Physiological, and Clinical Aspects

By World Health Organization

Book Id: WPLBN0000050757
Format Type: PDF eBook
File Size: 1.4 MB
Reproduction Date: 2005

Title:	World Health Organization : Technical Report Series, No. 397: Intra-Uterine Devices ; Physiological, and Clinical Aspects
Author:	World Health Organization
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago Organization, W. H. (n.d.). World Health Organization : Technical Report Series, No. 397. Retrieved from http://gutenberg.cc/

Description
Medical Reference Publication

Excerpt
1. INTRODUCTION 1. X Extent of present usage Since the previous Scientific Group meeting on this subject, intrauterine devices (IUDs) have been used for contraception by millions of women in all regions of the world. An estimate of the extent to which their use has spread in the past two years is given in Table 1. The countries listed in the table provide contraceptive services through their national health services and maintain records of their experience with IUDs under these programmes. Accurate figures for the use of IUDs in the private sector of medicine in these countries, and in other countries where the method is used chiefly in the private practice of medicine, are unavailable. In the USA it is known that by the end of 1967, the major manufacturers of IUDs had distributed over 3 000 000 devices, but it is impossible to ascertain how many have actually been used.

Table of Contents
CONTENTS Page 1 . Introduction . . . . . . . . . . . . . . . . . . 5 1.1 Extent of present usage . . . . . . . . . . 5 1.2 History . . . . . . . . . . . . . . . . . . 6 1.3 Design of IUDs . . . . . . . . . . . . . . 7 2 . Biological effects . . . . . . . . . . . . . . . . 7 2.1 Antifertility effects . . . . . . . . . . . . . 7 2.2 Systemic effects . . . . . . . . . . . . . . 8 2.3 Pelvic organ effects . . . . . . . . . . . . 9 3 . Tissue reactions . . . . . . . . . . . . . . . . 12 .3.1 The ovary . . . . . . . . . . . . . . . . 12 3.2 Thetube . . . . . . . . . . . . . . . . . . 12 3.3 The endometrium . . . . . . . . . . . . . 13 3.4 The myometrium . . . . . . . . . . . . . 14 3.5 The uterine fluid . . . . . . . . . . . . . 14 3.6 The cervix . . . . . . . . . . . . . . . . 14 3.7 The vagina . . . . . . . . . . . . . . . . 14 3.8 Carcinogenesis . . . . . . . . . . . . . . . 14 4 . Clinical experience . . . . . . . . . . . . . . . 16 4.1 Sources of data . . . . . . . . . . . . . . 16 4.2 Statistical methods and clinical trials . . . . 17 4.3 Contraceptive effectiveness . . . . . . . . . 18 4.4 Side effects and complications . . . . . . . 19 4.5 Continuation of use . . . . . . . . . . . . 24 4.6 Further factors affecting utilization . . . . .' 26 5 . Patient management . . . . . . . . . . . . . . 27 5.1 Indications . . . . . . . . . . . . . . . . 27 5.2 Contraindications . . . . . . . . . . . . . 27 5.3 Immediate medical care . . . . . . . . . . 28 5.4 Paramedical personnel . . . . . . . . . . . 28 5.5 Time of insertion . . . . . . . . . . . . . 28 5.6 Technique of insertion . . . . . . . . . . . 29 5.7 Follow-up care . . . . . . . . . . . . . . 29 5.8 Long-term safety . . . . . . . . . . . . . 30 6 . Future research needs . . . . . . . . . . . . . . 30 6.1 Basic research . . . . . . . . . . . . . . . 30 6.2 Clinical and epidemiological studies . . . . . 31