Leitura clínica
Comentário
Os dispositivos intrauterinos ( DIU ) são dispositivos de plástico flexível em forma de T que são introduzidos no útero. Podem ser revestidos com fio de cobre ou com levonorgestrel. Têm efeito anticoncepcional e podem ser usados inclusive como contraceptivo de emergência. (Manual MSD 2023, ACOG 2011) O DIU com cobre não altera a concentração de ceruloplasmina plasmática nem a de cobre no leite materno. (Rodrigues 2001) Não foram observados problemas de crescimento em lactentes de mães que utilizam DIU com cobre ou com levonorgestrel. (Berry 2016, Bahamondes 2013, Shaamash 2005, Díaz 1997) Não foram observados problemas de produção ou duração da amamentação (Berry 2016, Bjarnadóttir 2001, Díaz 1997, Sivin 1997, Sinchai 1995, Croxatto 1982), salvo algum caso de aumento de prolactina com ou sem galactorreia. (Giampietro 1984, Mehta 1977) Diversas sociedades médicas e autores especialistas consideram seguro o uso de DIU durante a amamentação. (Berry 2016, Berens 2015, Rowe 2013, CDC 2013 y 2011, CLM 2012, Prescrire 2009, FFPRHC 2004) e muitos aconselham sua inserção no pós-parto imediato. (OMS 2015, Mwalwanda 2013, Amir 2011) Há um leve maior risco de expulsão do DIU com a amamentação (Eggebroten 2017), especialmente se a inserção for feita durante o pós-parto imediato (ACOG 2016 ), por isso seria preferível colocá-lo após 4 semanas do parto. A maioria dos anti-inflamatórios, ou anestésicos locais ou gerais que eventualmente pudessem ser necessários para colocar ou retirar o DIU, é compatível com a amamentação.
Encontrabilidade
Outros nomes e marcas
Marcas comerciais na fonte 6
- Diu-Safe Cu/375
- GyneFix
- Multiload
- Paragard T380A
- TT 380
- UT 380
Rastreabilidade
Bibliografia
- Manual MSD Dispositivo intrauterino (DIU) on line 2023 Consultado el 22 de Noviembre de 2023 Texto completo (enlace a fuente original)
- MSD Manual. Intrauterine Devices (IUDs). on line. 2023 Consultado el 22 de Noviembre de 2023 Texto completo (enlace a fuente original)
- Eggebroten JL, Sanders JN, Turok DK. Immediate postpartum intrauterine device and implant program outcomes: a prospective analysis. Am J Obstet Gynecol. 2017 Jul;217(1):51.e1-51.e7. Resumen
- American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. Committee Opinion No. 670: Immediate Postpartum Long-Acting Reversible Contraception. Obstet Gynecol. 2016 Aug;128(2):e32-7. Resumen
- Berry-Bibee EN, Tepper NK, Jatlaoui TC, Whiteman MK, Jamieson DJ, Curtis KM. The safety of intrauterine devices in breastfeeding women: a systematic review. Contraception. 2016 Dec;94(6):725-738. Resumen Texto completo (enlace a fuente original)
- Berens P, Labbok M; Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.º 13: Anticoncepción durante la lactancia, revisado en 2015. Breastfeed Med. 2015 Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- OMS. Criterios médicos de elegibilidad para el uso de anticonceptivos Quinta edición. Who Library. 2015 Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- WHO. Department of Reproductive Health and Research World Health Organization. Medical eligibility criteria for contraceptive use: 20 years of global guidance. WHO/RHR/15.07. 2015 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Mwalwanda CS, Black KI. Immediate post-partum initiation of intrauterine contraception and implants: a review of the safety and guidelines for use. Aust N Z J Obstet Gynaecol. 2013 Resumen
- CDC. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Resumen
- Bahamondes L, Bahamondes MV, Modesto W, Tilley IB, Magalhães A, Pinto e Silva JL, Amaral E, Mishell DR Jr. Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth. Fertil Steril. 2013 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- CLM - Comité de Lactancia Materna de la AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Resumen
- ACOG. ACOG Practice Bulletin No. 121: Long-acting reversible contraception: Implants and intrauterine devices. Obstet Gynecol. 2011 Jul;118(1):184-196. Resumen
- Centers for Disease Control and Prevention (CDC). U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm Rep. 2010 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Prescrire [No authors listed]. Intrauterine devices: an effective alternative to oral hormonal contraception. Prescrire Int. 2009 Resumen
- Shaamash AH, Sayed GH, Hussien MM, Shaaban MM. A comparative study of the levonorgestrel-releasing intrauterine system Mirena versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development. Contraception. 2005 Resumen
- FFPRHC: Faculty of Family Planning & Reproductive Health Care. Guidance (July 2004): Contraceptive choices for breastfeeding women. J Fam Plann Reprod Health Care. 2004 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Rodrigues da Cunha AC, Dorea JG, Cantuaria AA. Intrauterine device and maternal copper metabolism during lactation. Contraception. 2001 Jan;63(1):37-9. Resumen
- Bjarnadóttir RI, Gottfredsdóttir H, Sigurdardóttir K, Geirsson RT, Dieben TO. Comparative study of the effects of a progestogen-only pill containing desogestrel and an intrauterine contraceptive device in lactating women. BJOG. 2001 Resumen
- Díaz S, Zepeda A, Maturana X, Reyes MV, Miranda P, Casado ME, Peralta O, Croxatto HB. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices. Contraception. 1997 Resumen
- Sivin I, Díaz S, Croxatto HB, Miranda P, Shaaban M, Sayed EH, Xiao B, Wu SC, Du M, Alvarez F, Brache V, Basnayake S, McCarthy T, Lacarra M, Mishell DR Jr, Koetsawang S, Stern J, Jackanicz T. Contraceptives for lactating women: a comparative trial of a progesterone-releasing vaginal ring and the copper T 380A IUD. Contraception. 1997 Resumen
- Sinchai W, Sethavanich S, Asavapiriyanont S, Sittipiyasakul V, Sirikanchanakul R, Udomkiatsakul P, Chantaeyoon P, Roybang K, Trakankamol J, Suti S, et al. Effects of a progestogen-only pill (Exluton) and an intrauterine device (Multiload Cu250) on breastfeeding. Adv Contracept. 1995 Jun;11(2):143-55. Resumen
- Giampietro O, Ramacciotti C, Moggi G. Normoprolactinemic galactorrhea in a fertile woman with a copper intra-uterine device (copper IUD). Acta Obstet Gynecol Scand. 1984;63(1):23-5. Resumen
- Croxatto HB, Díaz S, Peralta O, Juez G, Casado ME, Salvatierra AM, Durán E. Fertility regulation in nursing women. II. Comparative performance of progesterone implants versus placebo and copper T. Am J Obstet Gynecol. 1982 Sep 15;144(2):201-8. Resumen
- Mehta S, Pawar V, Joshi J, Kora S, Rajani U, Virkar KD, Raikar RS, Sheth AR. Serum prolactin levels in women using copper IUDs. Contraception. 1977 Mar;15(3):327-34. No abstract available. Resumen