Asymptomatic retraction of intrauterine device (IUD) threads into the cervical canal or uterine cavity is a common complication. We present the rare case of a 44-year-old woman with the threads ...protruding through an opening in the anterior cervical lip about 1 cm above the external cervical os. Despite this presentation, her management was straightforward. We review the literature and discuss the possible antecedents of the phenomenon in this patient.
A 34-year-old woman with Bipolar Affective Disorder attempted self-removal of an impalpable Implanon® from her arm with a pair of non-sterile implements, resulting in an infected and swollen arm. The ...device was removed after ultrasound imaging without any complications. This instance is useful for enhancing cognizance of the possibility of self-removal of contraceptive implants and the need for specific follow-up arrangements and timely appointments when a patient requests removal. It also underscores the need for a detailed history, including elucidation of past and current medical problems, in all women requesting contraception guidance.
Implanon®, a contraceptive implant, is increasingly being used because of its efficacy and nonuser-dependent nature. However, as for other steroid contraceptives, its efficacy can be reduced by ...enzyme-inducing drugs, such as antituberculous medication, resulting in unplanned pregnancy. We present the case of a 27-year-old para 1 + 0 referred to us for termination of a pregnancy that resulted from failure of Implanon during concomitant treatment with Rifinah® (a rifampicin-isoniazid combination). All health care providers should be aware of the adverse effects of hepatic enzyme inducers on hormonal contraceptives, obtain details of current contraceptive methods from women of reproductive age, and refer them to contraceptive and reproductive health care professionals as appropriate for optimal management. This will ensure that such women do not experience the psychologic trauma of a termination of pregnancy.
We present the case of a 26-year-old woman with retained fetal bones, discovered eight years after an induced mid-trimester abortion in a West African country. The patient had requested her general ...practitioner to change the intrauterine device (IUD) which she assumed had been inserted immediately post-abortion. No threads were seen on vaginal examination. A pelvic ultrasound examination showed features that were misinterpreted for an IUD in the cervical canal. At evacuation of the uterine cavity retained fetal bone fragments were recovered.
Objective
To assess the quality of patient leaflets regarding the choice between medical and surgical abortions.
Design
Cross sectional survey.
Setting
NHS and private providers of abortion services ...in England and Wales.
Sample
Leaflets from three private providers, all teaching hospitals (n= 14) and a representative sample of NHS district hospitals (n= 27), accessed by approximately 100,000 women per year.
Methods
On telephoning the above abortion services, the leaflets provided to women choosing to have medical or surgical abortions were requested. Content analysis of leaflets included: application of a coding frame assessing adequacy of information about options, risks and procedures; the Flesch Readability Ease scale.
Main outcome measures
Provision of leaflet, adequacy of information and ease of readability.
Results
Seventy‐three percent (44/60) of contacted providers offered women a leaflet. Of these 44 leaflets, one mentioned medical and 15 surgical abortion methods only. Adequacy of information provision was low, with on average 10/23 points covered about the surgical method, 12/21 points about the medical method and 7/11 points about aftercare. Readability scores were poor with 24/44 (55%) rated as ‘difficult’ or ‘fairly difficult’. Among NHS providers, scores were slightly higher in the teaching than in the district hospitals.
Conclusions
On average, leaflets provided half the information possible about the risks and procedures of medical and surgical methods. In addition, readability was rated as difficult in over half the leaflets. It seems unlikely that these leaflets enable women to make informed choices between abortion methods and, therefore, do not meet the requirements of current guidelines.
Babatunde A GboladeFertility Control Unit, Department of Obstetrics and Gynaecology, St James’s University Hospital, Leeds, West Yorkshire, UKAbstract: Implanon®, a contraceptive implant, ...is increasingly being used because of its efficacy and nonuser-dependent nature. However, as for other steroid contraceptives, its efficacy can be reduced by enzyme-inducing drugs, such as antituberculous medication, resulting in unplanned pregnancy. We present the case of a 27-year-old para 1 + 0 referred to us for termination of a pregnancy that resulted from failure of Implanon during concomitant treatment with Rifinah® (a rifampicin-isoniazid combination). All health care providers should be aware of the adverse effects of hepatic enzyme inducers on hormonal contraceptives, obtain details of current contraceptive methods from women of reproductive age, and refer them to contraceptive and reproductive health care professionals as appropriate for optimal management. This will ensure that such women do not experience the psychologic trauma of a termination of pregnancy.Keywords: etonogestrel implant, Implanon, contraceptive failure, unintended pregnancy, enzyme inducer, rifampicin
The value of symphysiotomy Oboh, Alex; Gbolade, Babatunde A
BJOG : an international journal of obstetrics and gynaecology
110, Številka:
8
Journal Article
PDF
