1248

2% of ectopic pregnancies were associated with IUD use, whereas from 1971 to 1975, 39% were. Their data also suggest that there may have been an additional small increase in ectopics which were not related to IUD use. Although no direct data are available for Britain, there is some evidence that a similar situation may exist here. Jonas reported that 14% (14 out of 103) of ectopic pregnancy admissions to Hillingdon Hospital between 1967 and 1974 were associated with an in situ IUD,6 as were 14% (3 out of 21) of deaths from ectopic pregnancy in England and Wales between 1973 and 1976.7 If since 1967 14% of hospital admissions for ectopic pregnancy were IUD-related, an annual average of about 450 ectopics in England and Wales would be associated with an in situ device. As in Finland, these 450 ectopic pregnancies would account for much but not all of the increase in ectopic pregnancy incidence. We

acknowledge

the

use

of unpublished data from O.P.C.S.

Epidemiological Monitoring Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT

NICOLA ROBINSON VALERIE BERAL

COLD-PRESSOR TEST

SIR,-Dr Watson and Professor Littler (Oct. 13, p. 803) the

are

of

measuring the haemodyright emphasise namic response to peripheral cold stimulation when using this test with gated cardiac blood pool scintigraphy in the detection of coronary heart disease (Aug. 18, p. 320). All our subjects had a significant increase in heart rate and mean blood pressure (ratexpressure product), and the responses in patients with coronary artery disease (CAD) or cardiomyopathy were similar to those in controls. The figure shows the comparative to

importance

reported to the British Cardiac Society last month) that, in patients undergoing gated blood pool imaging, cold stimulation detected significantly more CAD patients (41/48, 85%) than did isometric exercise (15/24, 62%) or dynamic exercise (13/21, 62%) (p

Cold-pressor test.

1248 2% of ectopic pregnancies were associated with IUD use, whereas from 1971 to 1975, 39% were. Their data also suggest that there may have been an...
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