=?utf-8?q?Yanıt: Re: Question for those of you inserti? =?utf-8?q?ng IUDs?
From: =?utf-8?q?Dr. Bülent Potur?= (bpotur@yahoo.com)
Wed Jul 25 12:11:52 2007
Well Dan,
I had just tried to emphasize the hypoestrogenic state
of lactating women and the case's similarity in the
insertion to a lactating woman in resembling the
vulnerability of the uteri of lactating women in the
quoted literature.
So I do not have the color doppler data of this case
or the 6 week post partum uteri in general.
Thank you.
Bulent Potur
--- "R. Daniel Braun" <rd.braun@gmail.com> wrote:
> I would disagree with the "avascular" part of your
> statement. At 6 weeks
> postpartum the uterus is still quite HYPERVASCULAR.
>
> Dan
>
> On 7/25/07, Dr. Bülent Potur <bpotur@yahoo.com>
> wrote:
> >
> > Below is a publication when I had found for a case
> report of mine. An
> > IUD diagnosed in the pouch of Douglas with vaginal
> ultrasound Dirim
> > Sep-Oct 2002 31-34) The case also was consistent
> with the majority of
> > the review below. The IUD had been inserted at
> 6th week post partum to
> > a lactating women. When the uterus was so thin
> and avascular and prone
> > to perforation The patient had been referred when
> the strings of the IUD
> > was not seen at check 2.5 months later insertion.
> > Bulent Potur MD Obgyn
> > Kirikkale TURKEY
> >
> > 1: Contraception. 1998 Apr;57(4):251-5.Click here
> to read Links
> > Perforations with intrauterine devices. Report
> from a Swedish survey.
> > Andersson K, Ryde-Blomqvist E, Lindell K,
> Odlind V, Milsom I.
> > Department of Obstetrics and Gynecology,
> Sahlgrenska University
> > Hospital, Göteborg, Sweden.
> > This survey comprised 50 consecutive perforations
> occurring with
> > intrauterine devices (IUD) reported to the
> National Patient Insurance
> > Scheme Register during 1990 to 1993. All 50 women
> were parous and > 20
> > years of age at the time of IUD insertion.
> Forty-two (84%) of the IUD
> > were inserted by a midwife and eight by a
> gynecologist. A total of 45
> > women (90%) had their IUD inserted < 1 year after
> a full-term pregnancy
> > and 31 women (62%) had their IUD inserted < or > 12 weeks after
> > delivery. Of the 50 women, 27 (54%) reported that
> they were
> > breastfeeding at the time of IUD insertion. No
> particular IUD was
> > overrepresented in relation to its share on the
> market. In 31 cases
> > (62%), severe pain at insertion and during the
> first 24 h was recorded.
> > In 14 women (28%), the perforation was diagnosed
> early (i.e., within 1
> > month of insertion) and in 36 women (72%), the
> perforation was diagnosed
> > > 1 month after insertion. Lower abdominal pain
> was the most frequent
> > symptom at early diagnosis but in two cases, the
> main symptom was heavy
> > bleeding. Among the 36 women in whom the
> perforation was discovered
> > more than 1 month after insertion, the diagnosis
> was made when an
> > unexpected pregnancy occurred in 20 women (56%).
> In 15 cases, the IUD
> > strings were not visible during pelvic examination
> at a routine
> > check-up, which led to efforts to locate the IUD.
> Thirty-two women
> > (64%) underwent laparotomy for removal. We
> conclude that lactating
> > women seem to be a risk group for perforation and
> that a national
> > register of IUD perforations could provide a
> better means of quality
> > control.
> > PMID: 9649917 [PubMed - indexed for MEDLINE]
> >
> > At Tue, 24 Jul 2007, GIN11153@aol.com wrote:
> > >
> > >Friend asked me about perforation rate. I don't
> have an answer but
> > thought
> > >that it is an accepted complication that is
> discussed in an informed
> > consent.
> > >Your thoughts, please!
> > >
> > >Gail Neuman RNC CPHW
> > >student midwife and student nurse practitioner
> > >certified high risk OB
> > >Perinatal Nurse Associates
> > >801 N. Tustin Ave., Suite 305
> > >Santa Ana, CA 92705
> > >(714) 314-7070
> > >(714) 838-1479 fax
> > >
> > >http://discover.aol.com/memed/aolcom30tour
> >
>
> --
> R. Daniel Braun, MD FACOG(L) CMT
> Professor Emeritus
> Dept. of Obstetrics and Gynecology
> Indiana U. School of Medicine
>
> R. Daniel Braun
>
> "Science without Religion is LAME; Religion
> without Science is BLIND"
> Einstein 1941
>
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