Intrauterine

As of 1994, there were approximately 47 progestin-containing contraceptive dmg formulations sold in the United States for use as oral contraceptives (Table 3). In addition, there are three nonoral contraceptive formulations containing progestins ie, one injectable (Depo-Provera), one as an intrauterine device (lUD) (Progestasert), and one implantable (Norplant). Of the oral formulations, all but two also contain an estrogen component, ethynylestradiol. 

Intrauterine devices are medical products that prevent conception when placed in the utems. In spite of their ancient origins, modem intrauterine devices (lUDs) have been widely used only in the last 30 years. The two generic subclasses of lUDs are nonmedicated (inert) devices and medicated lUDs, ie, progestin-releasing and copper lUDs. 

After insertion of an lUD, polymorphonuclear leukocytes and macrophages accumulate in the uterine cavity. These cells appear to phagocytize sperm and Hberate a blastotoxic toxin (92,93). Intrauterine devices also may create a hostile environment, perhaps because antibodies are produced that interfere with implantation of the fertilized ovum (93). 

R. L. Kleioman, Intrauterine Contraception, 4th ed.. International Plaimed Parenthood Federation, London, 1977. 

Intrauterine devices, Population Reports, Series B, no. 3, Population Information Program, The Johns Hopkius University, Baltimore, 1979. 

LRISis an intrauterine contraception device for use of not more than 5 years. 

Studies on the reproductive function (three generations) and intrauterine development of rat showed no impairment of the rate of fertility and no sign of any teratogenic effect. The Ames test on mutagenicity was negative [101]. 

Arvin AM, Alford CA (1990) Chronic intrauterine and perinatal infections. In Galasso GJ, Whitley RJ, Merigan TC (eds) Antiviral agents and viral diseases of man, 3rd edn. Raven,... 

Symposium on Intrauterine Diagnosis "Birth Defects Original Article Series", (1971), 2> 5. 

W. L. "Prospects for Radiographic Intrauterine Diagnosis -The Syndrome of Thrombocytopenia with Absent Radii". N. 

Kaback, M. M. and Howell, R. R. "Infantile Metachromatlc Leukodystrophy. Heterozygote Detection in Skin Fibroblasts and Possible Application to Intrauterine Diagnosis". New Engl. J. Med., (1970), 2S2, 1336-1340. 

C. J. "Intrauterine Diagnosis of Genetic Defects Results, Problems, and Follow-up of 100 Cases In a Prenatal Genetic Detection Center". Am. J. Obstet. Gynecol., (1974), 118> 897-905. 

Nadler, H. L. and Gerbie, A. B. "Role of Amniocentesis in the Intrauterine Detection of Genetic Disorders". 

IV rt-PA has been safely given in patients with cervical arterial dissection There are four reports of IV rt-PA use in pregnancy, with one case complicated by intrauterine hematoma,rt-PA should be used in this setting only after careful assessment of the risks and benefits. There is insufficient data to determine the benefit of rt-PA in the pediatric population, with no randomized trials. 

Lubchenco, L.O. Hansman, C. and Boyd. E. Intrauterine growth in length and head circumference as estimated from live births at gestational ages from 26 to 42 weeks. Pedi at.ri cs 37 404-408, 1966. 

P-Blockers Generally acceptable on the basis of limited data. Reports of intrauterine growth restriction with atenolol in the first and second trimesters. 

Oral, transdermal, and transvaginal contraceptives, as well as intrauterine devices and most barrier contraceptives, do not protect against sexually transmitted diseases. 

Intrauterine pregnancy, ectopic pregnancy, and miscarriage must be at the top of the differential diagnosis list for any woman presenting with heavy menses. 

Menorrhagia also may be treated with the levonorgestrel-releasing intrauterine device (IUD). This is a very effective treatment that consistently reduces menstrual flow by 90% or greater.29,30 Its use has resulted in the postponement or cancellation of scheduled endometrial resection surgery or hysterectomy. Specifically, 60% of treated patients have been able to avoid hysterectomy.30,34,35... 

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