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  1. 1
    081736
    Peer Reviewed

    A national study to monitor the safety of IUCD use.

    Richardson A; Paul C

    CONTRACEPTION. 1993 Apr; 47(4):359-66.

    To determine whether the known adverse effects of IUD use were kept to a minimum, 432 doctors were asked to complete questionnaires about their training and practice in IUD insertion, providing information about the insertion and the patient during a 3-month period. 349 doctors returned the first questionnaire. 93% of doctors had received some formal training in IUD insertion, although 54% had performed fewer than 5 supervised insertions before carrying out an unsupervised insertion. Only 8% had performed 10 or more supervised insertions. 58% had performed only 1 or no insertions in the month before the study period. 91% of respondents carried out more than 1 pelvic examination per week. Only 12% of doctors reported always prescribing prophylactic antibiotics. More doctors routinely took vaginal and cervical swabs for culture and cervical smears. 66% of doctors routinely arranged follow-up appointments. 98% of doctors routinely gave some information to women after IUD insertion. 90% of doctors provided a description of symptoms of infection. Information about women using an IUD was obtained from 129 doctors in 460 completed questionnaires about IUD insertions. Relative contraindications to IUD use included nulliparity, a history of suspected or proven pelvic inflammatory disease (PID), a significant risk of sexually transmitted disease (STD), and uncompleted family. Excluding uncompleted family, there were 126 insertions (27%) with at least 1 relative contraindication. Gynecologists performed 30% of the insertions in cases with relative contraindications compared with 48% for other doctors. 35 women who had IUDs inserted were nulliparous, and 4 of these were aged under 20, 11 women (2%) had an IUD inserted despite a history of suspected or proved PID. 12% of the women with IUDs were not in a stable sexual relationship; 9% had a history of STD, and 28% intended to have children in the future. 5% had both a risk factor for PID and an uncompleted family.
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