Electrocardiographic changes induced by insertion of an intrauterine device and other uterine manipulations.

ABSTRACT

A prospective study was carried out in normal women in order to investigate the effects of the following procedures on the electrocardiogram and blood pressure (1) insertion of an intrauterine device (IUD)--the Lippes loop, Tcu-200, uterine progesterone system or Cu-7; (2) endometrial biopsy; and (3) uterine flushing. In groups in which a large IUD like the Lippes loop and/or a stiff IUD like the Cu-7 was inserted, the frequency of bradycardia was significantly higher than in any other groups. The severity of the bradycardia was similar in all of the groups and the frequency of this alteration was also similar among the nulliparous women or in those who complained of pain during the instrumentation, irrespective of the type of IUD inserted or the procedure carried out. No alarming modifications of blood pressure were observed and maintaining the patients in the recumbent position was sufficient to alleviate symptoms. In severe cases use of the Trendelenburg position should be enough to correct any alterations.

ABSTRACT

PIP The effects of the insertion of an intrauterine device (IUD), endometrial biopsy, and uterine flushing on electrocardiograph patterns were evaluated in a prospective study of 260 women. The frequency of bradycardia was significantly higher during insertion of a Lippes loop IUD (p less than .001) or Cu-7 IUD (p less than .02) than with other procedures. The frequency of tachycardia was greater than that of bradycardia during the insertion of an uterine progesteronr system and TCu-200 IUD. However, the severity of bradycardia was similar in all groups. The frequency of bradycardia was similar among nulliparous women, and was correlated with reports of pain during any of the procedures. Changes in blood pressure were not severe, and symptoms were relieved by maintaining patients in a recumbent position. The Trendelenburg position is recommended in severe cases.