Risk factors for intrauterine device embedment in postmenopausal women: an analysis of 731 participants undergoing hysteroscopy.

OBJECTIVE: This study aimed to explore the risk factors for intrauterine device (IUD) embedment in postmenopausal women. METHODS: A total of 731 women who underwent hysteroscopy for IUD removal from January 2019 to December 2021 were included in the trial, of whom 301 were diagnosed with IUD embedment (embedded group) and 430 had a normal IUD location (control group). The following data were collected from electronic medical records: demographic traits, ultrasound findings, IUD shapes, uterine features, and hysteroscopy findings. Bivariate contingency analysis and multiple logistic regression were performed to identify the significant independent variables that affect IUD embedment. RESULTS: Prior IUD removal failure (14.3% vs 5.1%; adjusted odds ratio [aOR], 3.29; 95% CI, 1.90-5.71) and V-shaped IUD (18.9% vs 10.7%; aOR, 2.05; 95% CI, 1.33-3.16) were risk factors that were independently linked with IUD embedment. Uterine volume (22.7 [20.9-24.5] cm 3 vs 27.9 [24.8-30.9] cm 3 ; aOR, 0.99; 95% CI, 0.982-0.999) was negatively linked with IUD embedment. There were no differences in age, parity, menopause length, years with an IUD in situ, uterine position, or abortion times between the two groups. There were no differences in existing leiomyoma, prior cervical LEEP (loop electrosurgical excision procedure), or myomectomy between the two groups. CONCLUSIONS: Prior IUD removal failure, V-shaped IUD, and a smaller uterine volume were risk factors for IUD embedment in menopausal women.

Intrauterine Bakri Balloon and Vaginal Tamponade Combined with Abdominal Compression for the Management of Postpartum Hemorrhage.

OBJECTIVE: This study sought to investigate the effect of Bakri balloon use and vaginal tamponade combined with abdominal compression for the management of postpartum hemorrhage (PPH). METHODS: This retrospective study reviewed cases of PPH in the International Peace Maternal and Child Health Hospital of China Welfare Institution in Shanghai, China from January 1, 2010 to December 31, 2015. A single use of the intrauterine Bakri balloon was applied in some cases, and additional vaginal tamponade combined with abdominal compression (double compression) was applied in other cases. The authors evaluated the effect of these two methods in the management of PPH. RESULTS: The Bakri balloon was used in 305 cases of intrauterine PPH, and the clinical efficacy was 93.26%. One group of study patients underwent double compression, and these patients had a better clinical efficacy rate of 96.3% (157 of 163), whereas the efficacy in cases using the Bakri balloon alone (control group) was 87.3% (124 of 142). The postoperative complication rates of these two groups were 9.4% and 8.7%, respectively. Uterine arterial embolization was performed in patients in whom Bakri balloon use failed. None of the cases resulted in a hysterectomy. CONCLUSION: Intrauterine Bakri balloon use combined with vaginal tamponade and abdominal compression is more effective in the treatment of PPH compared with Bakri balloon use alone. This method does not increase postoperative complications. Uterine atony with placenta previa or implantation may be possible reasons for noneffectiveness of Bakri balloon use.