POPLINE Document Number: 690161
Author(s):
Tejuja S
Malkani PK
Source citation:
American Journal of Obstetrics and Gynecology, October 15, 1969;105(4):620-627.
Abstract:
The size of uterine cavities was measured by using the planimeter-hysterogram technique. Factors affecting this size were considered. The measured size of uterine cavities was correlated with the occurrence of side effects from subsequent insertion of Lippes loops. Subjects were 45 normal multiparous women. Hysterograms were done with Diagunal as the contrast medium. Visualization of the cervical canal was obtained by using a short-tipped Jarcho's uterine cannula to inject the dye. This device also prevented leakage of the dye into the vagina. The procedure was carried out under fluoroscopy, followed by 3 films in the anterior-posterior position. A film with the cannula in place served to determine measurements. The uterine cavity was considered as a plane since the anterior and posterior walls were almost in contact. A compensatory polar planimeter was used for measurements. Of the 45 women, 32 (71%) had uterine areas between 6-8 square cm. Neither age of patients nor parity was correlated with the size of the uterine cavity. The surface area of the individual, calculated from height, and weight with the Dubois chart had no influence on the size of the uterine cavity. The distance between the fundus and the uterine os varied from 2.9 to 6.4 cm, with most 4-6 cm. The distance between the 2 cornua was 2-3.1 cm. The width of the Lippes loops inserted after the tests was 27.5 mm. 30 of the 45 women had the distance between the cornua less than 27.5 mm. The Lippes loops were 25 mm long. All the subjects had uterine cavities longer than 25 mm. Follow-up studies for 2 years revealed that 60% of the patients had vaginal bleeding immediately after insertion of the Lippes loops and 40% had inc reased bleeding with subsequent menstrual periods. In these 40%, the ut erine area was 6 square cm or less in 55.5% of them. Of those with no s uch complaints only 3.7% had uterine areas of less than 6 square cm. In 30%, pain had followed the Lippes loop insertion. Of these, 60% had uterine cavity areas of 6 square cm or less. In those not having pain only 10% had measurements of 6 square cm or less. Removals of IUDs were made in 40% of these women because of these symptoms. Pregnancy occurred in 12 women within 1 year after removal of the IUDs. There were no expulsions. It is suggested that the frequency of vaginal bleeding and pain is related to the disparity between the size of the uterine cavity and that of the IUD, particularly the width of Lippes loops at present commonly in use (27.5 mm). Newer devices should reduce this width but could increase the length. Fewer side effects and greater acceptability would thereby be promoted.
Keywords:
IUD Side EffectsIndex page
IUD, Unmedicated
Uterus
Age Factors
Parity
Bleeding
Pain
Contraception Termination
Reversibility
Laboratory Procedures
Side Effects
IUD
Contraceptive Methods
Contraception
Family Planning
Genitalia, Female
Genitalia
Urogenital System
Physiology
Biology
Population Characteristics
Demographic Factors
Population
Fertility Measurements
Fertility
Population Dynamics
Signs and Symptoms
Diseases
Laboratory Examinations and Diagnoses
Examinations and Diagnoses
Treatment