Intrauterine Device Expulsion After Medication Versus Procedural Management of Induced and Spontaneous Abortion: A...

To compare intrauterine device (IUD) expulsion rates between medication and procedural abortion management for induced or spontaneous abortion and identify risk factors for expulsion.

We conducted a retrospective cohort study of patients undergoing medication or procedural management of induced or spontaneous abortion ≤10 weeks' gestation at a specialty clinic within a single academic center between 2010 and 2023. Included patients received a copper or levonorgestrel IUD at the time of uterine aspiration or within 30 days of medication management and had clinical or radiographical follow-up describing the IUD. The primary outcome was partial or complete IUD expulsion. Secondary analyses examined associations between clinical variables and expulsion risk.

Among 410 patients, 60 received medication for induced or spontaneous abortion, and 350 underwent procedural management for induced or spontaneous abortion. The IUD expulsion rate was 12% following medication management and 11% following procedural management, with no statistically significant difference. In a regression analysis, indication, treatment method, gestational age, and IUD type were not associated with IUD expulsion. Gravidity was the only independent risk factor (OR: 1.21; 95% CI: 1.09-1.35).

IUD expulsion rate after procedural or medication management of induced or spontaneous abortion was approximately 11% and did not differ by indication or treatment.