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Perforations with intrauterine devices. Report from a Swedish survey
K Andersson1, E Ryde-Blomqvist, K Lindell
1Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden.
Contraception
|July 3, 1998
Summary
Breastfeeding women are at higher risk for uterine perforation following intrauterine device (IUD) insertion. Early diagnosis and a national register can improve IUD safety and quality control.
Area of Science:
- Reproductive Health
- Medical Device Safety
- Gynecology
Background:
- Uterine perforation is a rare complication of intrauterine device (IUD) insertion.
- Understanding risk factors and diagnostic timelines is crucial for patient safety.
Purpose of the Study:
- To analyze the characteristics and outcomes of uterine perforations associated with IUDs.
- To identify potential risk factors and improve diagnostic strategies for IUD-related perforations.
Main Methods:
- Retrospective survey of 50 consecutive uterine perforation cases linked to IUDs.
- Data collected from the National Patient Insurance Scheme Register (1990-1993).
- Analysis of patient demographics, insertion circumstances, symptoms, diagnosis timing, and management.
Main Results:
- Most perforations occurred in parous women over 20, often inserted by midwives shortly after pregnancy.
- Breastfeeding at insertion was reported in 54% of cases, suggesting a potential risk group.
- Delayed diagnosis (>1 month) was common (72%), often prompted by unexpected pregnancy or non-visible IUD strings.
- Laparotomy was required for removal in 64% of cases.
Conclusions:
- Lactating women may represent a significant risk group for IUD-related uterine perforation.
- A national IUD perforation register could enhance quality control and patient safety.
- Improved awareness and diagnostic protocols are needed for timely identification of IUD perforations.