Microbial and cytopathological study of intrauterine contraceptive device users.

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dc.contributor.authorAgarwal, Krishnaen_US
dc.contributor.authorSharma, Ushaen_US
dc.contributor.authorAcharya, Veenaen_US
dc.date.accessioned2004-09-08en_US
dc.date.accessioned2009-05-29T06:16:21Z
dc.date.available2004-09-08en_US
dc.date.available2009-05-29T06:16:21Z
dc.date.issued2004-09-08en_US
dc.description.abstractCONTEXT: Intrauterine contraceptive device (IUCD) is a commonly used birth-spacing method which is fitted into maternal system. Clinical, microbial and cytopathological monitoring of women using these devices are important for ascertaining their side effects, risk of genital tract infection and carcinogenic potential. AIMS: To study clinical, microbial and cytopathological changes in IUCD users in a tertiary care hospital. DESIGN: Prospective analytic. SETTING: Tertiary hospital. MATERIAL AND METHODS: women visiting Family Planning clinic for follow up (IUCD users, n=100) or for IUCD insertion (controls, n=50) were enrolled in the study. Each subject underwent detailed history, general physical, systemic, and per local examination. Vaginal discharge was subjected to pH testing, KOH and wet mount examination, gram staining, and for culture and sensitivity. Bacterial vaginosis was defined using Nugent criteria. Cervical smears were examined and reported as per Bethesda system. STATISTICAL ANALYSIS: The information was entered into Microsoft Excel spreadsheet. The results were analyzed using EPI Info version-6 and Stata statistical software version 7 packages. Two-tailed t-test, chi2 test with Yates correction and two-tailed Fisher Exact tests were applied. RESULTS: Most women used CuT 200 (92%). Median duration of use was 2 years. Chief complaints of IUCD users included backache (54%), vaginal discharge (46%), pain lower abdomen (34%), dyspareunia (22%), menorrhagia (18%) and dysmenorrhea (14%). Mean hemoglobin was lower in IUCD users than controls (11.2+/-1.7 versus 11.9+/-1.8 g/dL, p 0.02). Proportion of women with anemia was higher in IUCD users than in controls (29% versus 16%, p 0.12). Cervical erosion was significantly increased in study group as compared the controls (20% versus 0%, p=0.00) whereas only insignificant increase in vaginitis (6% versus 0%, p=0.17). Trichomonas vaginalis and fungal hyphae positivity and gram stain findings and bacterial vaginosis rate were not significantly different in two groups. Vaginal discharge bacterial culture revealed comparable results in two groups. Cytological findings were predominantly inflammatory. None of cases revealed Actinomycosis infection. High-grade squamous intraepithelial lesion (n=2) and low grade squamous intraepithelial lesion (n=1) cytological finding were present in IUCD users compared to none in controls. None of the cases had any malignant transformation. CONCLUSION: IUCD use results in lower hemoglobin concentration and cervical erosion. Women using IUCD requires a regular follow up, clinical examination, counseling and further investigation if required.en_US
dc.description.affiliationDepartment of Obstetrics and Gynaecology, SMS Medical College, Jaipur, India. aranag@rediffmail.comen_US
dc.identifier.citationAgarwal K, Sharma U, Acharya V. Microbial and cytopathological study of intrauterine contraceptive device users. Indian Journal of Medical Sciences. 2004 Sep; 58(9): 394-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/68618
dc.language.isoengen_US
dc.source.urihttps://www.indianjmedsci.orgen_US
dc.subject.meshAdulten_US
dc.subject.meshBacterial Infections --microbiologyen_US
dc.subject.meshCopperen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshIntrauterine Devices --microbiologyen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshUterine Cervical Diseases --microbiologyen_US
dc.subject.meshUterus --microbiologyen_US
dc.subject.meshVaginal Smearsen_US
dc.titleMicrobial and cytopathological study of intrauterine contraceptive device users.en_US
dc.typeClinical Trialen_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
dc.typeRandomized Controlled Trialen_US
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