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Increase in IUD Expulsions the IUD on Sterile Paper 65-67-JFPRHC Jan 07 12/12/06 5:15 PM Page 2 Letters to the editor/News roundup J Fam Plann Reprod Health Care: first published as 10.1783/147118907779399558 on 1 January 2007. Downloaded from the end of the stopper ring and since then I never Slimline® intrauterine device (IUD), following devices now available are of the ‘Slimline’ type, failed. Many colleagues have tried this method the publication of the letter from Drs Hawkins the product is still described as ‘380 A’ on its and they have had success with it also. and Callander in the October 2006 issue of the packaging!) I had correspondence from the French Journal concerning IUD expulsions.1 Notwithstanding all of the above remarks, company that unless the article were to be Neither Durbin PLC, nor the French the manufacturer of the TT 380 Slimline device, endorsed by a professor or senior manufacturer (7-MED Industrie), can explain in view of the volume now used in the UK, have consultant/colleague in family planning then they what has happened, although the clinical skills of proposed some design changes purely for the UK were not prepared to change the design. The the two doctors are beyond reproach. Since 2002 Ortho Gynae T 380® was discontinued, however approximately 205 000 TT 380 Slimline devices market. These changes, which will be on stock it has been adopted for use by other have been fitted in France alone, with only three produced from January 2007, will result in an manufacturers with only minor changes, and I am reported expulsions. increase in the resistance to expulsion. afraid the inherent problem is still present. One There is a European Standard for the Any readers requiring further information, has tried to make loading easier but still the ‘resilience’ of the horizontal arms which the TT evaluation samples, and so on, are invited to problem doesn’t disappear completely. 380 Slimline meets, and the manufacturer does contact me directly. My proposal was very simple: no matter how not accept that the way the arms regain their you load the introducer rod in the tube it should shape after compression is connected to the Colin G Parker come out outside the top opening and then one reported expulsions. Manager, Clinic Sales, Durbin PLC, can be absolutely sure that the IUD is released I would refer the Journal’s readers to the South Harrow, Middlesex, UK. totally and completely and that there is no chance poster presentation by Dr Paul O’Brien of the IUD being pulled down. (Westminster PCT, London, UK) at the 8th E-mail: [email protected]. For those colleagues who would like to try Congress of the European Society of my technique they should do the following. Put Reference Contraception held in Edinburgh, UK in June 1 Hawkins F, Callander F. Increase in IUD expulsions the IUD on sterile paper. Pull the IUD out further 2004. (NB. Copies of the poster are available (Letter). J Fam Plann Reprod Health Care 2006; 32: up so that one does not cut the thread. Line the from me on request.) This poster reviewed 267. rod against the tube with the rod just a few published studies on the T380 ‘A’ version millimetres (say 4–5 mm) higher than the (where the copper sleeves on the horizontal Ancient condoms opening and then the lower end of the tube should arms stand proud of the plastic) and the T380 Further to the article in the October 2006 issue be cut, which should rest at the end of the rod ‘Slimline’ version (where the copper on the of the Journal on the history of condoms,1 where there is a ring. Subsequent fitting should arms is flush with the plastic and closer to the now be easier. ends), which may cast some light on the readers may be interested to know that amongst topic. the finds in Tutankhamen’s tomb was a linen Rajendra Prasad Yadava, FRCGP, FFFC Dr O’Brien’s review revealed an increase in condom with long strings to attach. The condom General Practitioner and Instructing Doctor, expulsions in the first year with the ‘Slimline’ is now on show in the Cairo Museum alongside Merton Surgery, Longton, Stoke-on-Trent UK. version compared to the ‘A’ version. By Years 4 the more famous artefacts, which goes to show E-mail: [email protected] and 5 the expulsion rates with both types were that one can’t be too careful – even in the similar. References afterlife! 1 Hawkins F, Callander F. Increase in IUD expulsions The T-Safe 380 A changed to the ‘Slimline’ (Letter). J Fam Plann Reprod Health Care 2006; 32: format in June 2005. The results of Dr Hawkins 267. Lesley Smith 2 Yadava RP. Self removal of Mirena IUS (Letter). Br J and Callandar refer to T-Safe usage up to Autumn Curator, Tutbury Castle, Tutbury, Staffordshire, Fam Plann 1997; 22: 59. 2005. Allowing for the stock holding in the UK. E-mail: [email protected] distribution chain, it is probable that most of the T-Safe devices fitted in the period referred to Reference Increase in IUD expulsions were of the original ‘A’ style. (NB. It is 1 Edouard L. In condoms we trust: to each, one’s own. I write as the UK distributor for the TT 380 interesting to note that although all the T-Safe J Fam Plann Reprod Health Care 2006; 32: 262–264. NEWS ROUNDUP EURAS Study results a three-fold increase compared to those whose VTE associated with the use of any combined Final results of the European Active BMI was 25–29. Increasing age was also a OC pill, with a similar odds ratio to that found Surveillance (EURAS) Study were presented at significant risk factor. in previous studies. However, in 2005 there was the XVIII FIGO World Congress of Obstetrics No increase was seen in risks of arterial no significant difference in VTE risk in this http://jfprhc.bmj.com/ and Gynaecology in Kuala Lumpur, Malaysia on disease for any preparation, compared to non- population of women taking a gestodene- 9 November 2006. This post-marketing users. The study results are to be published in containing pill compared to a levonorgestrel- surveillance cohort study took place between the journal, Contraception, early in 2007. containing pill. It is important to note that this 2000 and 2006, with 58 674 participants study was designed to reduce potential followed up for 1421475 woman-years. The aim Reported by Anne Szarewski, PhD, FFFP confounders and biases by using controls with of the study was to monitor cardiovascular Editor-in-Chief, Journal of Family Planning the same year of birth from this same region of outcomes in combined oral contraceptive (COC) and Reproductive Health Care Austria as the identified cases. The cases users, specifically comparing those on Yasmin® included those who had VTEs diagnosed and with other COC users. The scale of the study, Risk of VTE with oral treated in an outpatient setting as well as amount of detailed information collected about contraceptives inpatients. on October 1, 2021 by guest. Protected copyright. each woman (with regard to relevant A free communication presented at the XVIII The authors conclude that their cardiovascular risk factors) and the fact that FIGO World Congress of Obstetrics and contemporary study results differ from those only 2.39% of women were lost to follow-up Gynaecology in Kuala Lumpur, Malaysia found in the 1990s because user populations of make this a unique and useful investigation. investigated whether gestodene-containing oral second- and third-generation OC pills have As has been noted in previous studies of contraceptive (OC) pills carried a higher risk of changed. cardiovascular risks, women using the newest venous thromboembolism (VTE) compared to preparation (in this case Yasmin) were at levonorgestrel-containing OCs. A population- Reference slightly higher risk at entry (e.g. were more based case-control study was undertaken in 1 Heinemann L, Dinger J, Assmann A. The risk of likely to be obese). Interim results of this study 2005 amongst Austrian women aged between 15 venous thromboembolism (VTE) in oral contraceptives: a new lesson. Presentation at the had already shown higher than expected and 49 years. Interim results were presented XVIII FIGO World Congress of Obstetrics and absolute risks of venous thromboembolism involving 408 cases and 1339 controls. The odds Gynaecology, Kuala Lumpur, Malaysia, 5–10 (VTE) in all groups, and the final results showed ratio for developing a VTE with an OC versus November 2006. a risk for non-pregnant, non-COC users of 44 non-use was 2.8 (95% CI 2.1–3.6) for all OCs, per 100 000 woman-years. All COC users, 2.7 (95% CI 1.9–3.8) for gestodene-containing Reported by Diana Mansour, FRCOG, FFFP regardless of preparation, had a similar, elevated OCs and 2.9 (95% CI 1.5–5.8) for Consultant in Community Gynaecoloy and risk of VTE, at approximately 90 per 100 000 levonorgestrel-containing OCs. A head-to-head Reproductive Health Care, Newcastle woman-years. The risk was increased to 230 per comparison comparing gestodene-containing Contraception and Sexual Health Service, 100 000 in women with a body mass index versus levonorgestrel-containing OCs showed Graingerville Clinic, Newcastle General (BMI) over 30, which was a five-fold increase an odds ratio of 1.2 (95% CI 0.6–2.7). Hospital, Newcastle-upon-Tyne, UK. E-mail: compared to women whose BMI was 20–24 and This study confirmed an increased risk of diana.mansour@ newcastle-pct.nhs.uk 66 ©FFPRHC J Fam Plann Reprod Health Care 2007: 33(1).
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