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  • Title: Concluding remarks.
    Author: Hafez ES.
    Journal: Contracept Deliv Syst; 1980 Jul; 1(3):288-93. PubMed ID: 12336391.
    Abstract:
    Focus in this discussion of IUDs is on types of IUD, fitting and insertion of IUDs, IUD management, physiology of IUDs, IUD pathology and management, and future development of IUDs. Several clinical trials are now underway in the effort to develop an IUD which will be able to lower the rate of pregnancies, expulsions, pain, bleeding, infections and other complications associated with IUD use. The use of proper techniques for insertion and placement of IUDs reduces the risk of uterine perforation, expulsion, pregnancy menstrual bleeding, pain and pelvic inflammatory disease. The device should be placed as high as possible in the endometrial cavity without perforating the uterine wall. In the absence of contraindications, IUDs can be used in adolescent females. The correct model should be selected and adapted individually to the sometimes underdeveloped uterine cavity. Side effects and complications of IUDs include uterine pain, dysfunctional uterine bleeding, expulsions, perforations, pelvic inflammatory disease, accidental intrauterine pregnancy and ectopic pregnancy. Novel approaches for future IUD improvement include medicated IUDs, medicated IUDs with compounds to reduce bleeding, IUDs designed to reduce expulsion after early postpartum and postabortion insertion, improved fit of IUD size and configuration to a given uterus, better insertion techniques and instrumentation, and application of biodegradables and polymeric delivery system.
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