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Routine Pathology for IntrauterineDevices and Therapeutic Abortion: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Routine Pathology for IntrauterineDevices and Therapeutic Abortion: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Routine Pathology for IntrauterineDevices and Therapeutic Abortion: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Routine Pathology for Intrauterine (...) Devices and Therapeutic Abortion: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: September 12, 2019 Project Number: RC1176-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical utility of routine pathology for removed intrauterinedevices? What is the clinical utility of routine pathology for therapeutic abortions? What is the cost-effectiveness of routine pathology
HIV incidence among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterinedevice, or a levonorgestrel implant for contraception: a randomised, multicentre, open-label trial. Observational and laboratory studies suggest that some hormonal contraceptive methods, particularly intramuscular depot medroxyprogesterone acetate (DMPA-IM), might increase women's susceptibility to HIV acquisition. We aimed to compare DMPA-IM, a copper intrauterinedevice (IUD (...) ), and a levonorgestrel (LNG) implant among African women seeking effective contraception and living in areas of high HIV incidence.We did a randomised, multicentre, open-label trial across 12 research sites in eSwatini, Kenya, South Africa, and Zambia. We included HIV-seronegative women aged 16-35 years who were seeking effective contraception, had no medical contraindications to the trial contraceptive methods, agreed to use the assigned method for 18 months, and reported not using injectable, intrauterine
2019LancetControlled trial quality: predicted high
Self-administered vaginal lidocaine gel for pain management with intrauterinedevice insertion: a blinded, randomized controlled trial A major barrier to intrauterinedevice use is fear of pain during insertion. Trials exploring analgesic interventions for intrauterinedevice insertion have yielded mixed results, and no standardized pain management guidelines currently exist for this procedure. In an abortion-related study, self-administered lidocaine gel over a prolonged time interval showed (...) promise as a method of pain control.The objective of the study was to assess pain control with intrauterinedevice insertion after patient-administered lidocaine gel compared with placebo.We conducted a randomized, blinded trial of women undergoing levonorgestrel or copper intrauterinedevice insertion in an outpatient gynecology clinic between July 2016 and April 2017. Participants self-administered either 20 mL of 2% lidocaine gel or placebo gel vaginally at least 15 minutes prior to intrauterine
Effect of topical glyceryl trinitrate cream on pain perception during intrauterinedevice insertion in multiparous women: A randomized double-blinded placebo-controlled study. Intrauterine contraceptive device (IUD) insertion-related pain presents a push beyond the decline of women to use IUD for family planning. We aimed to investigate the analgesic effect of glyceryl trinitrate cream (GTN) in reducing pain during IUD insertion.We conducted a randomized double-blinded placebo-controlled study
A prospective, randomized study evaluating the pain felt during intrauterinedevice insertion by the direct technique vs conventional technique. To assess the value of the direct insertion technique compared to the conventional insertion technique in reducing the pain experienced during placement of an intrauterinedevice (IUD).A prospective, controlled, randomized, single-blind trial was conducted in women eligible for IUD insertion. Participants were randomized into two groups: "conventional
Paracervical Block for IntrauterineDevice Placement Among Nulliparous Women: A Randomized Controlled Trial To investigate whether a 20-mL buffered 1% lidocaine paracervical block decreases pain during intrauterinedevice (IUD) placement.In a randomized, single-blind, placebo-controlled trial, women were assigned to receive either a 20-mL buffered 1% lidocaine paracervical block or no block before IUD placement. The primary outcome was pain with IUD placement measured on a 100-mm visual analog
Adolescents and Long-Acting Reversible Contraception: Implants and IntrauterineDevices e130 VOL. 131, NO. 5, MAY 2018 OBSTETRICS & GYNECOLOGY Adolescents and Long-Acting Reversible Contraception: Implants and IntrauterineDevices ABSTRACT: The phenomenon of adolescent childbearing is complex and far reaching, affecting not only the adolescents but also their children and their community. The prevalence and public health effect of adolescent pregnancy reflect complex structural social problems (...) and an unmet need for acceptable and effective contra- ceptive methods in this population. In 2006–2010, 82% of adolescents at risk of unintended pregnancy were currently using contraception, but only 59% used a highly effective method, including any hormonal method or intrauterinedevice. Long-acting reversible contraceptives (LARC) have higher efficacy, higher continuation rates, and higher satisfaction rates compared with short-acting contraceptives among adolescents who choose to use them
Immediate postpartum levonorgestrel intrauterinedevice insertion and breast-feeding outcomes: a noninferiority randomized controlled trial Immediate postpartum levonorgestrel intrauterinedevice insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes.This study examined the effect of immediate vs delayed postpartum levonorgestrel intrauterinedevice insertion on breast-feeding outcomes.We conducted (...) this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel intrauterinedevice. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery <37.0 weeks' gestational
Reducing Pain During IntrauterineDevice Insertion: A Randomized Controlled Trial in Adolescents and Young Women To estimate the effect of a 1% lidocaine paracervical nerve block on pain during intrauterinedevice (IUD) insertion compared with a sham block in adolescents and young women.We conducted a multisite, single-blind, sham-controlled randomized trial in adolescents and young women having a 13.5-mg levonorgestrel IUD inserted. Enrollment occurred at three family planning clinics
Endoscopic Treatment of IntrauterineDevice Migration into the Bladder with Stone Formation Background: An intrauterinedevice is commonly used for contraception globally. Although intrauterinedevice placement is an effective and safe method of contraception, migration into the bladder with stone formation is a rare and serious complication. The management approaches for an intrauterinedevice embedded in the bladder include endoscopic procedures and open surgical removal. In this study, we (...) report the case of a patient with recurrent urinary tract infection associated with intrauterinedevice migration and urolithiasis, who successfully underwent endoscopic treatment combined with laser fragmentation. Case Presentation: A 22-year-old woman presented to our hospital with a 1-month history of lower abdominal pain, hematuria, and pain on urination. Transvaginal ultrasound showed a hyperechoic lesion in the bladder. A plain abdominal radiograph showed the presence of a T-shaped intrauterine
Use of intrauterinedevices in nulliparous women Clinical Guidelines Use of intrauterinedevices in nulliparous women Patricia A. Lohr a, ? , Richard Lyus b , Sarah Prager c a British Pregnancy Advisory Service, 20 Timothy's Bridge Road, Stratford Enterprise Park, Stratford on Avon, Warwickshire, CV37 9BF b Homerton University Hospital, London c University of Washington Received 18 August 2017; accepted 23 August 2017 Abstract Five intrauterinedevices (IUDs) are available in the United States (...) : four levonorgestrel-releasing intrauterine systems (two containing 52 mg, one containing 19.5 mg and one containing 13.5 mg) and one copper-bearing device (Copper T 380A). All IUDs have very low typical- use failure rates and high acceptability ratings, yet they are used by a minority of women, with nulliparous women less likely to do so than parous women. The objective of this clinical review is to give evidence-based recommendations for the use of IUDs in nulliparous women
Long-Acting Reversible Contraception: Implants and IntrauterineDevices Long-Acting Reversible Contraception: Implants and IntrauterineDevices - ACOG Menu ▼ Long-Acting Reversible Contraception: Implants and IntrauterineDevices Page Navigation ▼ Number 186, November 2017 (Replaces Practice Bulletin Number 121, July 2011) Committee on Practice Bulletins—Gynecology . This Practice Bulletin was developed by the Committee on Practice Bulletins—Gynecology and the Long-Acting Reversible (...) , incurred in connection with this publication or reliance on the information presented. Long-Acting Reversible Contraception: Implants and IntrauterineDevicesIntrauterinedevices and contraceptive implants, also called long-acting reversible contraceptives (LARC), are the most effective reversible contraceptive methods. The major advantage of LARC compared with other reversible contraceptive methods is that they do not require ongoing effort on the part of the patient for long-term and effective use
Self-Administered Lidocaine Gel for IntrauterineDevice Insertion in Nulliparous Women: A Randomized Controlled Trial To evaluate self-administration of vaginal lidocaine gel to decrease pain with intrauterinedevice (IUD) insertion in nulliparous women.In this randomized, double-blind, placebo-controlled trial, women self-administered 2% lidocaine or placebo vaginal gel 5 minutes before IUD insertion. The primary outcome was change in pain from baseline to IUD insertion on a 100-mm visual
New developments in intrauterinedevice use: focus on the US Many more women in the US today rely upon intrauterinedevices (IUDs) than in the past. This increased utilization may have substantially contributed to the decline in the percentage of unintended pregnancies in the US. Evidence-based practices have increased the number of women who are medically eligible for IUDs and have enabled more rapid access to the methods. Many women enjoy freedom to use IUDs without cost, but for many
Intrauterinedevices and risk of uterine perforation: current perspectives Uterine perforation is an uncommon complication of intrauterinedevice insertion, with an incidence of one in 1,000 insertions. Perforation may be complete, with the device totally in the abdominal cavity, or partial, with the device to varying degrees within the uterine wall. Some studies show a positive association between lactation and perforation, but a causal relationship has not been established. Very rarely (...) , a device may perforate into bowel or the urinary tract. Perforated intrauterinedevices can generally be removed successfully at laparoscopy.
Ketorolac for Pain Control With IntrauterineDevice Placement: A Randomized Controlled Trial To evaluate intramuscular ketorolac compared with placebo saline injection for pain control with intrauterinedevice (IUD) placement.We conducted a randomized, double-blind, placebo-controlled trial between July 2012 and March 2014. Patients received 30 mg ketorolac or placebo saline intramuscular injection 30 minutes before IUD placement. The primary outcome was pain with IUD placement on a 10-cm
Increasing Access to Contraceptive Implants and IntrauterineDevices to Reduce Unintended Pregnancy Increasing Access to Contraceptive Implants and IntrauterineDevices to Reduce Unintended Pregnancy - ACOG Menu ▼ Increasing Access to Contraceptive Implants and IntrauterineDevices to Reduce Unintended Pregnancy Page Navigation ▼ Number 642, October 2015 (Replaces Committee Opinion Number 450, December 2009) (Reaffirmed 2018) Committee on Gynecologic Practice Long-Acting Reversible (...) Contraception Working Group This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Increasing Access to Contraceptive Implants and IntrauterineDevices to Reduce Unintended Pregnancy ABSTRACT: Unintended pregnancy persists as a major public health problem in the United States. Although lowering unintended pregnancy rates requires