[Intrauterine contraception with copper-T 200 device- a retrospective analysis of 334 cases (author's transl)]

Abstract

A review is given of the findings obtained in 334 women in whom a Cu-T 200 intrauterine device had been inserted at least two years previously and regular follow-up examinations were subsequently undertaken. The most frequent indications were an expressed preference for IUD on the patient's part (38.3%), poor tolerance to the "pill" (24.8%) and so-called "pill fatigue" (11.1%). Varicose veins led to IUD preference in 8.1% and thromboembolic disease in 6.-%. The failure rate - with 12 pregnancies - was 3.6%, all within 6 months of insertion of the device. Half of the pregnancies went to full term and resulted in the birth of mature, healthy babies. The most frequent complication were menstrual disturbances (20.1%). pain (19.5%), cervicitis (18.3%), and adnexitis (13.8%), necessitating removal of the device in 5.7%, 4.2%, 5.1%, and 0.6% of all cases for the afore-mentioned reasons, respectively. These rates are relatively high. The expulsion rate of 2.7% was relatively low, however. Further analysis of the complications led to the observation that menorrhagia was relatively common in nulliparae and in women with retroversion of the uterus, whereas the pre-insertion finding of a pressure-sensitive uterus with a normal ESR, led in a significantly higher percentage of cases to pain and adnexitis. The diagnosis by vaginal probe of a reduced uterine length led to faulty positioning and an increased tendency to pain in a significantly higher number of cases. The fact that only 56.6% of all women tolerated intrauterine contraception well and remained totally symptom-free supports th view held by us that even today the "pill" remains the contraceptive of choice and should be recommended as such.

PIP: A review is given of the findings obtained in 334 women in whom an IUD had been inserted at least 2 years previously. Regular follow-up examinations were subsequently undertaken. The most frequent indications were an expressed preference for an IUD on the part of the patient (38.3%), poor tolerance of the pill (24.8%), and pill fatigue (11.1%). Varicose veins led to IUD preference in 8.1% and thromboembolic disease in 6.0%. The failure rate, 12 pregnancies, was 3.6%, all within 6 months of device insertion. 1/2 of the pregnancies went to term and resulted in the birth of mature, healthy babies. The most frequent complications were menstrual disturbances (20.1%), pain (19.5%), cervicitis (18.3%), and adnexitis (13.8%), necessitating removal of the device in 5.7%, 4.2%, 5.1%, and 0.6% of all cases respectively. These rates are relatively high. The expulsion rate of 2.7% was relatively low. Further analysis of the complications led to the observation that menorrhagia was relatively common in nulliparae in women with a retroversion of the uterus, whereas the preinsertion finding of a pressure-sensitive uterus with a normal ESR, led in a significantly higher percentage of cases, to pain and adnexitis. The diagnosis by vaginal probe of a reduced uterine length led to faulty positioning and an increased tendency to pain in a significantly higher number of cases. The fact that only 56.6% of all women tolerated IUDs well and remained totally symptom-free, supports the view held by us that even today the pill remains the contraceptive of choice and should be recommended as such. (author's)