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Acute neurovascular sequelae of intrauterine device insertion or removal.

1973; National Institutes of Health; Volume: 11; Issue: 5 Linguagem: Inglês

Conrad Cc, Mahdi Ghazi, Kitay Dz,

Cardiac Arrhythmias and Treatments

This paper documents the occurrence of convulsions and syncope following IUD insertion or removal. 6 cases which occurred among 7140 IUD procedures at the Grady Memorial Hospital Atlanta the Planned Parenthood clinic and Georgia Health Dept. family planning clinic are detailed. A 27-year-old multipara with a history of a single convulsion in childhood (after stepping on a nail) had a grand mal seizure immediately following insertion of a Lippes Loop D. She recovered promptly and was released with the IUD in place. On followup there were no further reports of seizures. A 17-year-old nulligravida gave a history of epilepsy and schizophrenia. It was later determined she had omitted the medication for epilepsy that morning. Immediately following the removal of a Lippes Loop which had been inserted the previous day she had a typical epileptic seizure. The third case with no history of neurologic disorders seizures or syncope developed shock-like symptoms immediately following insertion of a small Lippes Loop. After removal of the IUD she recovered promptly. The fourth and fifth cases were both 22-year-old-nulligravidas. One had a typical grand-mal seizure during insertion and a second shortly after. The other woman suffered profuse diapharesis pallor weakness thready pulse nausea and vertigo. In each case the IUD was removed and the patient seemed normal. In the sixth case with similar normal background cramping pain nausea vomiting and fainting followed insertion of a Lippes Loop A. After removal the patient returned to normal. Similarities of this syndrome to shock symptoms and to symptoms associated with cervical dilation are recognized. It is recommended that a history of a seizure disorder or vascular instability be routinely obtained prior to manipulation of an IUD.