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Intraperitoneal levonorgestrel-releasing intrauterine device following uterine perforation: the role of progestins in adhesion formation.
Hum Reprod. 2003 May; 18(5):990-3.HR

Abstract

BACKGROUND

Intrauterine contraception is a widely used, highly effective means of birth control. Uterine perforation is a serious, albeit rare, complication of intrauterine device (IUD) use. Although uterine perforation by levonorgestrel-releasing (20 micro g/day) intrauterine system (LNG-IUS) has already been reported, the peritoneal adhesion potential of this IUD is unknown.

METHODS

The medical files of all patients diagnosed with an intra-peritoneal IUD between the years 1990-2002 at Hadassah Medical Center were reviewed. Histopathological study of peritoneal adhesion tissue adjacent to levonorgestrel medicated IUD was conducted in one case.

RESULTS

Eight cases of dislocated IUDs were found. Four cases used LNG-IUS and four other cases used copper-IUD. Laparoscopy for IUD removal disclosed mild local peritoneal adhesions between omentum and pelvic organs in all cases. No difference was noted in the appearance of the peritoneum in the presence of either a copper-IUD or LNG-IUS. Histological examination of peritoneal tissue encasing the levonorgestrel-intrauterine system revealed loose connective tissue with aggregates of submesothelial cells with a pseudo-decidual change. Immunohistochemical staining for progesterone receptor was negative.

CONCLUSIONS

The peritoneal adhesions potential of LNG-IUS is low, similar to that of the copper-bearing IUD.

Authors+Show Affiliations

Department of Obstetrics and Gynecology and Department of Pathology, Hadassah University Hospital, Jerusalem, Israel. rkochman@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12721174

Citation

Haimov-Kochman, Ronit, et al. "Intraperitoneal Levonorgestrel-releasing Intrauterine Device Following Uterine Perforation: the Role of Progestins in Adhesion Formation." Human Reproduction (Oxford, England), vol. 18, no. 5, 2003, pp. 990-3.
Haimov-Kochman R, Doviner V, Amsalem H, et al. Intraperitoneal levonorgestrel-releasing intrauterine device following uterine perforation: the role of progestins in adhesion formation. Hum Reprod. 2003;18(5):990-3.
Haimov-Kochman, R., Doviner, V., Amsalem, H., Prus, D., Adoni, A., & Lavy, Y. (2003). Intraperitoneal levonorgestrel-releasing intrauterine device following uterine perforation: the role of progestins in adhesion formation. Human Reproduction (Oxford, England), 18(5), 990-3.
Haimov-Kochman R, et al. Intraperitoneal Levonorgestrel-releasing Intrauterine Device Following Uterine Perforation: the Role of Progestins in Adhesion Formation. Hum Reprod. 2003;18(5):990-3. PubMed PMID: 12721174.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraperitoneal levonorgestrel-releasing intrauterine device following uterine perforation: the role of progestins in adhesion formation. AU - Haimov-Kochman,Ronit, AU - Doviner,Victoria, AU - Amsalem,Hagay, AU - Prus,Diane, AU - Adoni,Amiram, AU - Lavy,Yuval, PY - 2003/5/2/pubmed PY - 2004/1/15/medline PY - 2003/5/2/entrez SP - 990 EP - 3 JF - Human reproduction (Oxford, England) JO - Hum. Reprod. VL - 18 IS - 5 N2 - BACKGROUND: Intrauterine contraception is a widely used, highly effective means of birth control. Uterine perforation is a serious, albeit rare, complication of intrauterine device (IUD) use. Although uterine perforation by levonorgestrel-releasing (20 micro g/day) intrauterine system (LNG-IUS) has already been reported, the peritoneal adhesion potential of this IUD is unknown. METHODS: The medical files of all patients diagnosed with an intra-peritoneal IUD between the years 1990-2002 at Hadassah Medical Center were reviewed. Histopathological study of peritoneal adhesion tissue adjacent to levonorgestrel medicated IUD was conducted in one case. RESULTS: Eight cases of dislocated IUDs were found. Four cases used LNG-IUS and four other cases used copper-IUD. Laparoscopy for IUD removal disclosed mild local peritoneal adhesions between omentum and pelvic organs in all cases. No difference was noted in the appearance of the peritoneum in the presence of either a copper-IUD or LNG-IUS. Histological examination of peritoneal tissue encasing the levonorgestrel-intrauterine system revealed loose connective tissue with aggregates of submesothelial cells with a pseudo-decidual change. Immunohistochemical staining for progesterone receptor was negative. CONCLUSIONS: The peritoneal adhesions potential of LNG-IUS is low, similar to that of the copper-bearing IUD. SN - 0268-1161 UR - https://www.unboundmedicine.com/medline/citation/12721174/Intraperitoneal_levonorgestrel_releasing_intrauterine_device_following_uterine_perforation:_the_role_of_progestins_in_adhesion_formation_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/deg203 DB - PRIME DP - Unbound Medicine ER -