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  • Title: [Cytologic picture of smears from the cervix uteri of women using intrauterine contraceptive devices (IUD)].
    Author: Wagrowska-Danilewicz M, Gwóźdź AZ, Danilewicz M.
    Journal: Ginekol Pol; 1988 Dec; 59(12):724-7. PubMed ID: 3254840.
    Abstract:
    During 1986-87, cervical smears were taken at various phases of menstrual cycles from 63 women aged 25-53 (average age of 34.8 years) wearing IUDs for 3 months to 17 years for the sake of cytological evaluation. 43 patients had Copper T-devices of Finnish make, 8 women had Spider Ws of Polish make, 1 had a Lippes Loop, and 10 had IUDs whose manufacturer could not be verified. The samples were preserved in an alcohol-ether solution, dyed with hematoxylin and eosin, and evaluated according to the 5-degree Papanicolaou scale. The presence of granulocytes indicative of inflammation was ranked: few granulocytes (+), the normal count in healthy women during anovulation wearing no IUDs; an adequate number of granulocytes (++); numerous granulocytes (+++); and a high number of granulocytes (++++). Cytogram II of the Papanicolaou scale was found in 49 women, and cytogram I in 14 women. 5 of 25 women wearing IUDs for 3 years had cytogram I, while 20 had cytogram II. Among 21 patients wearing IUDs for 2 years, there were 4 cases of cytogram I and 17 instances of cytogram II. Women with IUD use of 4-17 years were put into the second group, while all 4 of those with 3 months to 1.5 years of IUD use were listed in the first group. The remaining 6 were sorted into the second group. In 45 (71%) women, varying degrees of inflammation were detected in the presence of neutrophilic granulocytes. In 14 cases (22%) the presence of erythrocytes was demonstrated: few in 7 cases, an adequate number of 4, and an excess number in 3 cases caused either by the IUD or by hormone-induced cervical bleeding. Numerous neutrophilic granulocytes were found in 4 cases and a high number of them in 1 case. The granulocyte count was 10 (+), 17 or 16 (++), 12 (+++), and 6 (++++) indicating moderate or severe inflammation in most preparations. The presence of cytologically suspect or atypical cells was absent in the cervical smears of longterm IUD users. In most women, IUD use was associated with inflammation indicated by the increased number of granulocytes. The persistence of such inflammation may justify the removal of the IUD.
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