The development of commercial urinary pregnancy tests kits with high sensitivity to HCG (human chorionic gonadotropin) and the recent discovery that human sperm contain a substance that is immunologically chemically and biologically similar to HCG led investigators to consider the possibility that urine samples contaminated with sperm could produce false-positive pregnancy test results. Urine samples were collected from 30 women. For each urine sample 6 sets of 5 specimen were diluted with fresh semen in ratios of 1:10 1:25 1:50 1:100 1:250 and 1:500 and 1 set of 5 specimens was left undiluted. These different types of specimens were then subjected to 5 different pregnancy tests. The 5 pregnancy test kits used in the investigation were 1) Sensi-Tex; 2) Neocept; 3) Placentex; 4) UCG; and 5) Pregnosis. Only 1 false-positive reading was obtained. This reading was for a specimen diluted at a ratio of 1:10. The results demonstrated that test acccuracy was not affected by the presence of semen in the urine.
100 puerperial women were selected to receive a single dose of norethindrone enanthate (NET) which should hypothetically provide contraceptive protection for 3 months postinjection to give them sufficient time to select an adequate contraceptive method permit lactation during puerperium and allow return of normal menstrual and reproductive fucntions. The dose was 200 mg of NET. The patients were observed postinjectio at 3 months 6 months and 1 year. Method acceptability in this population was excellent. No pregnancies occurred at 3 months. Lactation was unaffected by the treatment. Therewere however temporary side effects reported by 30% of the patients although these effects did not require treatment. At 3 months 50% of the patients had bleeding a normal flow in 15% of cases and spotting in 35%. By 6 months both of these figures were 10%. 14% of patients suffered amenorrhea (and all were lactating) and 36% were menstruating normally at 3 months reaching a figure of 70% at 6 months.
The type and frequency of gynecological complications detected 6-12 months after fimbriectomy are reported in this clinical (retrospective) study of 106 cases of fimbriectomy patients sterilized either via abdominal or vaginal route. These cases were selected randomly for radiological studies and clinical follow-up. Operative complications observed in 5.8% of patients operated via the vaginal route included perforation of rectum (n=1) laceration of the mesosalpinx (1) blood loss greater than 300 ml (1) and abdominal bleeding from an ovarian cyst (1). Immediate postoperative complications reported in 13.2% of vaginal route operations included endometritis urinary tract infection and infected hematoma of the vaginal vault. In 10.5% of the minilaparotomy abdominal cases the immediate postoperative complications were abdominal wound infection (2) salpingitis (1) and pelviperitonitis (1). 53 vaginal route cases reported these complications 12 months postsurgery: dysmenorrhea (25%) hydrorrhea (13.2%) menometrorrhagia (11.7%) oligomenorrhea (10.3%) and dyspareunia and abdominal pain (7.4%). In 30 abdominal route cases the following 12 complications were reported: menometrorrhagia (21%) dysmenorrhea (18.4%) oligomenorrhea and hydrorrhea (15.8%) and dyspareunia and abdominal pain (10.5%). Radiological investigations showed that by the vaginal route bilateral hydrosalpinx occurred in 47% of cases unilateral hydrosalpinx in 20.5% and tubal patency (bilateral) in 4.4%. Abdominal route cases showed bilateral hydroxalpinx in 21% unilateral hydrosalpinx in 18.4% and uni- or bilateral tubal patency in 5.2%. Hydrosalpinx occurred more frequently (P < .02) via vaginal route.
4 years of experience with the TCu 220C (901 women; 28,071 woman months of use) - a long-acting multisleeved copper IUD - are analyzed. Event rates were calculated by life-table analysis with a computer program on an IBM 370/148-OS/VS1. Net cumulative rates at 4 years were as follows: pregnancy 3.3, expulsion 5.2, removal for bleeding, pain and other medical reasons 7.7, and 4.3 respectively. The incidence of pregnancy, expulsions, and removal for bleeding/pain decreases with time. Parity influences the performance of the TCu 220C. It seems to affect the pregnancy rate only marginally, but the expulsion and removal rates (for bleeding, pain, or other medical reasons) are higher in the nulliparae, and the same trends appear to be present for women of lower age groups. The IUD insertion technique seems to be important when determining the effectiveness of the method. The expulsion rate is significantly higher when the push-in technique (without sounding) is used, and the same tendency is present for pregnancies and removals for bleeding/pain, albeit to a lesser degree. Refraining from sounding the uterus and pushing-in the TCu 220C introduces the risk of not inserting the IUD high enough into the uterine cavity and therefore increases the risk of expulsion.
