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Sickle Cell Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Progestin-containing contraception agents are safe among women with sickle cell disease; these include depot medroxyprogesterone acetate (DMPA), etonogestrel implants and the levonorgestrel intrauterine device [39, 40]. The copper intrauterine device system is a safe, effective, and excellent choice in these women. A 2012 systematic review of eight studies found no evidence that either combined or progestin-only hormonal contraception in women with sickle cell disease increased their rate of complications [41].
SBA Questions
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
A 45-year-old mother of three had a copper intrauterine device (Cu-IUD) inserted 4 months ago for contraceptive purposes. Since then, she has suffered from spotting and sometimes heavier and longer bleeding periods. She has attended because she is frustrated and wants to have the device removed. What would be the most appropriate step to take in this woman?Offer hysteroscopy and biopsyPrescribe a low-dose combined oral contraceptive pill for a few monthsReassure her and reassess in 2 months if the bleeding continuesRemove the device and offer her a hysteroscopyScreen for infection and cervical pathology and once excluded, continue with contraception
Lactic acid, citric acid, and potassium bitartrate non-hormonal prescription vaginal pH modulator (VPM) gel for the prevention of pregnancy
Published in Expert Review of Clinical Pharmacology, 2022
The current rate of unintended pregnancy, 45% of all pregnancies, is unacceptably high; the addition of new contraceptive methods with various mechanisms of action and available in different formulations has great potential to improve this rate. The majority of effective contraceptive options available in the U.S. contain hormones. While offering highly effective contraception, many women have concerns about using hormonal contraception and desire to avoid previously-experienced or perceived side effects. Additionally, many women have contraindications to use of hormonal contraception due to medical history or smoking. Non-hormonal reversible methods are limited to the copper intrauterine device (IUD), barrier methods, and spermicides. The copper IUD, although highly effective and long-acting, can worsen heavy menstrual bleeding and dysmenorrhea, and requires a clinician for insertion in the uterus, a procedure that is associated with discomfort and which is considered by some to be invasive. Spermicides and barrier methods, while easily accessible over-the-counter and typically requiring little advanced planning, have a higher failure rate, while the increased risk of HIV transmission further limits use of spermicides. Some methods may be difficult to find, such as the female condom or sponge. Other methods such as the IUD, and the conventional fitted and Caya diaphragms and cervical cap require a doctor’s visit and advance planning prior to use.
Intrauterine device penetrating the anterior urinary bladder wall discovered during caesarean section: a case report
Published in Journal of Obstetrics and Gynaecology, 2020
Goda Jievaltienė, Dominyka Surgontaitė, Rosita Aniulienė, Donatas Venskutonis
A copper intrauterine device (IUD) is a reliable means to prevent pregnancy. Despite its contraceptive effectiveness, copper IUDs, like every measure for pregnancy prevention, can cause complications. They can be related not only to IUD-released active substances that alter the natural environment of the genital tract, but also to uterine perforation and IUD migration. According to literature, 0.4 out of 1000 women suffer from uterine perforation caused by an IUD (Kaislasuo et al. 2012). This article describes a rare case when a copper IUD was found penetrating the anterior wall of the bladder during a caesarean section.
Levonorgestrel emergency contraception and bodyweight
Published in Current Medical Research and Opinion, 2019
László Kardos, Gabriella Magyar, Eszter Schváb, Eva Luczai
Emergency contraception (EC) is an effective means of preventing pregnancy in the event of unprotected sexual intercourse (UPSI) or failure of a regular contraceptive method1. Current options include the copper intrauterine device, and oral preparations, including progestogens or progesterone receptor modulators.