To explore the possible clinical use of prostaglandin inhibitors in the control of IUD complications, 70 women with bleeding problems due to IUDs which had been inserted for at least 6 months were given indomethacin, a prostaglandin inhibitor. 25 others were given a placebo. Patients with active bleeding were immediately given the drug for 3 days; others were instructed to use it 2 days before and 2 days after menstruation. The dosage was 1 capsule (25 mg) orally 3 times a day. 90% of the menorrhagic test subjects had a satisfacory outcome (arrest of bleeding within 48 hours), as did 95% of the women with intermenstrual bleeding and 95% of those taking indomethacin prophylactically. .01). The main drawback of indomethacin use is gastric upset; rectal suppositories might reduce the incidence of this side effect. In addition, since the IUD is not 100% effective against pregnancy, there is a risk of exposing a fetus to the drug early in gestation.
To determine blood loss in 129 multigravidae undergoing first-trimester abortion by vaccum aspiration, hemoglobin was measured in the aspirate and calculated. Total hemoglobin was measured before and 2 weeks after the operation. Mean age of the patients was 29.6; mean duration of pregnancy was 11 weeks (range, 8-13 weeks). Blood loss averaged 64 + or - 48 ml in women 8-10 weeks pregnant, 107 + or - 82 ml in 11-13 weeks pregnant. Overall, the mean was 92 + or - 74 ml. Hemoglobin loss was 8.4 + or - 6.3 gm for those 8-10 weeks pregnant, 13.9 + or - 10.3 gm for those 11-13 weeks pregnant, and 11.9 + or - 9.5 gm overall. Loss of blood in multigravidae was less than that shown by primigravidae in an earlier study. Blood loss was not significantly affected by age or parity. Total hemoglobin was lower 2 weeks after the oepration than before, but this may have been due to aphysisiological reasction, since the decline did not correlate with blood loss at the time of abortion.
