Migration of an intrauterine device into the bladder: a rare case.

INTRODUCTION: Intrauterine device (IUD) application has been used for over 30 years and is a widely accepted contraception method among women because of its low-complication rates. The use of intrauterine devices may cause complications but migration of the IUD into an adjacent organ is rarely encountered. CASE: In the present report, we present a 26-year-old patient to whom IUD had been applied 2 years ago and whose examination performed due to pain and urinary complaints revealed migration of the uterine device into the bladder. CONCLUSION: Patients with pelvic pain and chronic irritative urinary symptoms whose vaginal examination and ultrasonography reveal a dislocated IUD should be carefully examined for the migration of the IUD into the bladder. In order to avoid this rare complication, patient should be evaluated physically and ultrasonographically for uterine position, thinness of the uterine wall and inflammatory disease before the insertion. The patient should be evaluated with sonography immediately after insertion and periodically.

Does manual removal of the placenta affect operative blood loss during cesarean section?

OBJECTIVE: To investigate whether manual removal of the placenta is associated with significantly more blood loss compared to spontaneous separation of the placenta during cesarean section. STUDY DESIGN: This was a randomised study of 200 women with normal pregnancies undergoing cesarean section. Patients were randomly assigned to the study group, manual removal (n=100) or the control group, spontaneous separation (n=100). Operative blood loss was measured using a volume and gravimetric method. Patients postoperative complications were recorded and hemoglobin levels measured at 24 and 48 h. RESULTS: The amount of blood loss associated with spontaneous and manual removal of the placenta was 626+/-253 ml and 589+/-272 ml, respectively. This difference was not significant. There was a decrease in the postoperative hemoglobin levels in both groups which was not significantly different. The incidence of endometritis, wound infection, and the need for blood transfusion was similar in the two groups. CONCLUSION: Manual delivery of the placenta is not associated with a significantly greater risk of operative blood loss, decreased postoperative hemoglobin levels or increased incidence of endometritis compared with spontaneous placental separation.