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[Intrauterine contraception from the viewpoint of an ambulatory gynecologic department].


 The history, current status, indications and contraindications for intrauterine contraception are described, information on safety and side effects is cited from the literature, and the experience of 1 clinic with IUDs is discussed. In 1976, 200,000 women in the German Democratic Republic used IUDs, or 50/1000 women aged 15-45. Intrauterine contraception had a slower and less steady development than oral contraception. The most widely used 2nd generation IUDs in East Germany were manufactured of plastic in the USSR, while the DANA copper and copper-T are the most widely used 3rd generation devices. The last days of the menstrual period are the best times for insertion, but placement immediately following abortion or birth is also possible. IUDs are indicated in cases where hormonal contraception is contraindicated. Contraindications to IUD use include suspicion of pregnancy, genital infection, atypical cytological finding, serious menstrual disturbances or bleeding of unknown cause, myomatous uterus, genital neoplasia, and deformation of the cervix or uterine cavity. The most significant complications and side effects of IUD use are bleeding disorders, dysmenorrhea, expulsion of the IUD, inflammation of the pelvic organs, undesired pregnancy, extrauterine pregnancy, and perforation of the uterus. Data from a gynecological clinic serving a predominantly rural area on 121 patients who used IUDs for a variety of reasons between June 1975 and August 1980 are presented. Observations covered a total of 4309 cycles and averaged 35.6 cycles per woman. Average age of patients was 31.7 years, no insertions were done in nulliparous patients, and the longest user had an IUD in place for 94 months. 29 patients had DANA superlux, 61 had DANA cor, 10 had DANA copper, and 21 had copper T devices. Complications and side effects were observed in 32 cases, including 19 cases of bleeding problems, of which 6 required removal; 5 of pregnancy, all of which were ended by abortions and which imply a Pearl Index of 1.4 pregnancies/100 woman years; 2 cases of adnexitis; and 2 cases of expulsion. 18 IUDs were removed, including 6 because of bleeding, 5 for pregnancy, 2 spontaneously expelled, 2 during hysterectomies, 2 because of desire for pregnancy, and 1 because of menopause.
