Assessment of a simplified insertion technique for intrauterine devices
Assessment of a simplified insertion technique for intrauterine devices
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DOI：
10.1016/j.ijgo.2015.12.004
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发表时间：
2016-07-01
影响因子：
3.8
通讯作者：
Blumenthal, Paul D.
中科院分区：
文献类型：
--
作者：
Christenson, Kamilee;Lerma, Klaira;Blumenthal, Paul D.
目的：探讨一种简易的宫内节育器（IUD）放置方法。研究方法：本前瞻性纵向研究招募了2013年6月1日至2014年6月30日期间在斯坦福大学妇科诊所接受IUD插入的年龄至少为18岁的患者。放置宫内节育器前未进行盆腔检查或子宫探通。插入后立即和4-6周时进行经阴道超声检查，以确认器械放置。主要结局是成功放置IUD。结果：本研究共纳入50例患者。在40例（80%）参与者中，宫内节育器插入成功，无需任何宫颈操作。任何手术均不需要探测。10例（20%）患者需要使用宫颈扩张器定位内口。宫内节育器和子宫内膜边缘之间的平均距离为2.9毫米后立即插入。宫内节育器插入被评为“困难”的医生进行的程序中的3例（6%）。未记录穿孔。3例（6%）患者发生宫内节育器脱落;其中2例患者的月经过多是宫内节育器插入的适应症。结论：在没有盆腔检查和探测的情况下放置宫内节育器是可行的;这种技术可以减少在插入过程中使用仪器的需要，从而减少与插入相关的疼痛。(C)2016年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: To explore a simplified technique for intrauterine device (IUD) insertion. Methods: The present prospective longitudinal study enrolled patients aged at least 18 years presenting at the gynecology clinic of Stanford University for IUD insertion between June 1, 2013 and June 30, 2014. No pelvic examination or uterine sounding was performed prior to IUD insertion. Transvaginal ultrasonography was performed immediately after insertion and at 4-6 weeks to confirm device placement. The primary outcome was successful IUD placement. Results: The study enrolled 50 patients. IUD insertion was completed successfully without any cervical manipulation in 40 (80%) participants. Sounding was not needed for any procedures. A cervical dilator was required to locate the internal os for 10 (20%) patients. The mean distance between IUDs and the endometrial verge immediately following insertion was 2.9 mm. IUD insertion was rated "difficult" by the physician performing the procedure in 3 (6%) patients. No perforations were recorded. IUD expulsion occurred in 3 (6%) patients; menorrhagia was the indication for IUD insertion in two of these patients. Conclusion: IUD insertion without prior pelvic examination and sounding was feasible; this technique could reduce the need for instrument use during insertion and, consequently, the pain associated with insertion. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.