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Re: Lost IUD From: Doc Peró (pero@fibertel.com.ar) Tue Mar 27 10:14:00 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Previous message: Jamie: "Re: Lost IUD" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Does "patient`s demand" means that we must/should/will accept it ??????? What if a given nuligravid patient, develops PID???? Are the ones who accept to insert IUD on mulis, clear enough describing method`s risks BEFORE doing it????? I`ve never accepted to insert them on nulis. Jorge. -----Mensaje original----- De: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] En nombre de Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. Enviado el: Martes, 27 de Marzo de 2007 08:06 a.m. Para: Multiple recipients of list OB-GYN-L Asunto: Re: Lost IUD At Mon, 26 Mar 2007, R. Daniel Braun wrote: > >Mirena's don't show up very well on flat plate especilly if she has a high >BMI >US is acutally the method of choice. If she is not obese and you don't see >it on U/S, it ain't in the uterus. >So she has alreaady had all the imaaging tht she needs, Since mirena does >not have any closed loops or copper, it really doesn't need to be removed >from abdominal cavity. So don't worry about it, except that she needs >contraception. >Vast majority will have been expelled undetected. >Those that perf ute happen at insertion and are almost always associated >with severe cramping during the insertion. > >Dan > Excellent points Dan, I am not so sure if it is sitting next to the uterus the amenorrehea will not persist the levonogesterol may be close enough to continue to have an effect. I have removed non merina's , from the culde suc probably perforated through the posterioir lower uterine segment, fundus perforated but not through the serosa and uterosacral ligaments. They were removed when doing laproscopy for pain/infertility, I usually found varring degrees of scarring. Have also found them by the diaphram and sitting in omentum. If They perforate at insertion but not nessarily completely they will often just tent the serosal peritenium. Severe cramping durring inserstion is non specific I usually order an ultrasound and have yet to see a perforation. I hate inserting then in nuligravids but they have become so popular I have had patients demand them. -- Take care, John -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.446 / Virus Database: 268.18.18/734 - Release Date: 26/03/2007 02:31 p.m. -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.5.446 / Virus Database: 268.18.18/734 - Release Date: 26/03/2007 02:31 p.m. Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Previous message: Jamie: "Re: Lost IUD" In reply to: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: Lost IUD"

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