Abstract
The majority of studies on the clinical events following the insertion of an intrauterine device for contraception have observed a higher frequency of adverse effects in nulliparous women. In this review, the significance of nulliparity on the occurrence of medical removal for bleeding and pain, expulsion and pelvic inflammatory disease is estimated. The possible role of the anatomy of the pregravid uterus is discussed, and results obtained through a selective measurement of the endometrial cavity in a population of nulligravidas is presented.
It is concluded that IUDs should not be the first choice of contraception in nulliparous women because of an increased risk of long-term adverse effects. The relationship between the length of the intrauterine device and the length of the endometrial cavity does not seem to be of clinical significance for the performance of IUDs in nulliparous women.
Resumé
La majorité des études sur les événements cliniques faisant suite à l'insertion d'un dispositif contraceptif intra-utérin ont fait état d'une fréquence plus élevée d'effets contraires chez les femmes nullipares. La présente étude examine l'incidence de la nulliparité sur le retrait effectué pour des raisons médicales telles que des saignements et des douleurs, l'expulsion et des maladies pelviennes inflammatoires. Elle examine le rôle possible de l'anatomie de l'utérus prégravide et présente les résultats obtenus lors de mensurations sélectives de la cavité endométriale dans une population de nullipares.
L'étude conclut que les dispositifs intra-utérins ne devraient pas constituer le premier choix de contraception pour les femmes nullipares en raison du risque accru d'effets défavorables à long terme. Le rapport entre la longueur du dispositif et la longueur de la cavité endométriale ne semble pas avoir d'importance du point de vue clinique sur l'efficacité des DIU chez les femmes nullipares.
Resumen
La mayoría de los estudios sobre acontecimientos clínicos tras la inserción de un dispositivo anticonceptivo intrauterino han observado una frecuencia más alta de efectos desfavorables en las mujeres nulíparas. En el presente estudio se examina la incidencia de la nuliparidad sobre el retiro efectuado por razones médicas, como pérdidas y dolores, expulsión y enfermedades pélvicas inflamatorias. Se examina el posible papel de la anatomía del útero pregrávido y se presentan los resultados obtenidos mediante la medición selectiva de la cavidad del endometrio en una población de nulíparas.
Se llega a la conclusión de que los dispositivos intrauterinos no deberían constituir la primera elección de anticonceptivo para las mujeres nulíparas por el mayor riesgo de efectos desfavorables a largo plazo. La relación entre la longitud del dispositivo y la longitud de la cavidad del endometrio no parece tener importancia clínica en cuanto a la eficacia de los DIU en las mujeres nulíparas.
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Petersen, K.R., Brooks, L., Jacobsen, B. et al. Intrauterine devices in nulliparous women. Adv Contracept 7, 333–338 (1991). https://doi.org/10.1007/BF02340179
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DOI: https://doi.org/10.1007/BF02340179