Twelve-Month Outcomes of Rotated Copper Intrauterine Devices After Immediate Postpartum Insertion
Thais Bezerra Vasconcelos de Castro1, Aureliana Barboza da Silva Nóbrega2, Conrado Milani Coutinho3
1Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto - SP, Brazil; Lauro Wanderley University Hospital (HULW), Federal University of Paraiba (UFPB), João Pessoa - PB, Brazil.
Objective(S):
To describe clinical outcomes of copper intrauterine devices (Cu-IUDs) inserted immediately postpartum that subsequently assumed a rotated position.
Study Design:
Secondary analysis of a postpartum IUD cohort using medical record data from women with rotated Cu T380A IUDs identified by transvaginal ultrasound 30-120 days after delivery who elected to maintain the device and were followed for 12 months.
Results:
Among 2,105 insertions, 1,813 had follow-up data available. Ninety-three devices (5.1%) were rotated. Of these, 73 asymptomatic women elected to maintain the device and were followed for 12 months. Partial uterine perforation occurred in 24 (32.9%), partial expulsion in 2 (2.7%), and no pregnancies were observed. Overall, 35 women (47.9%) discontinued use, primarily due to perforation.
Conclusions:
Rotated postpartum Cu-IUDs were not associated with pregnancy and rarely expelled but frequently progressed to partial uterine perforation.
