Objective
To investigate pregnancy outcome in patients who conceived with an intrauterine contraceptive
device.
Study Design
A retrospective study comparing the pregnancy outcome of women with retained intrauterine
device (n = 98), patients after intrauterine device removal in early pregnancy (n
= 194), and pregnancies without an intrauterine device (n = 141,191) was performed.
Results
A significant linear association was documented among the 3 groups and adverse outcomes
such as preterm delivery (18.4% in the retained intrauterine device, 14.4 % in removed
intrauterine device, and 7.3% in the no-intrauterine device group; P < .001) and chorioamnionitis (7.1% in the retained intrauterine device, 4.1% in removed
intrauterine device and 0.7% in the no-intrauterine device group; P < .001). The presence of retained or removed intrauterine device was found as an
independent risk factor for both preterm delivery and chorioamnionitis in multivariable
models.
Conclusion
Women conceiving with an intrauterine device are at increased risk for adverse obstetric
outcomes, whereas the risk is higher for pregnancies with retained intrauterine device
compared with early intrauterine device removal.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The intrauterine device (IUD)—worth singing about.Progress in Reproductive Health Research, World Health Organization. 2002; 60: 1-8
- Long-term reversible contraception twelve years of experience with the TCu380A and TCu220C.Contraception. 1997; 56: 341-352
- Mechanisms of the contraceptive action of hormonal methods and intrauterine devices (IUDs).Family Health International, 2006
- IUDs block fertilization.Network Family Health International. 1996; : 16
- Mechanisms of action of intrauterine devices: update and estimation of postfertilization effects.Am J Obstet Gynecol. 2002; 187: 1699-1708
- 6aIUDs and ectopic pregnancy.Contraception. 1995; 52: 321-322
- 6bOutcomes of pregnancy with an IUD in situ - a population based case-control study.Adv Contracept. 1988; : 265-270
- Ectopic pregnancy risk when contraception fails.J Reprod Med. 2002; 47: 881-885
- Two cases of abortion and premature birth after removal of a levonorgestrel-releasing intrauterine system.Eur J Contracept Reprod Health Care. 2002; 7: 244-246
- Pregnancy outcome with removal of intrauterine device.Obstet Gynecol. 1973; 41: 894-896
- Pill, IUD users run no increased risk of ectopics, malformation, miscarriage in planned pregnancies.Fam Plann Perspect. 1980; 12: 156-157
- Do contraceptive methods pose fetal risks?.Res Front Fertil Regul. 1985; 3: 1-11
- Pregnancy despite IUD: adverse effects on pregnancy evolution and fetus.Contraception. 2003; 68: 35-38
- Ectopic IUD complicating pregnancy.J Reprod Med. 2002; 47: 57-59
- The evaluation of 318 intrauterine pregnancy cases with an intrauterine device.Eur J Contracept Reprod Health Care. 2005; 10: 266-271
- Selected practice recommendations for contraceptive use.2nd ed. World Health Organization, Geneva, Switzerland2004
- Uterine rupture: differences between a scarred and an unscarred uterus.Am J Obstet Gynecol. 2004; 191: 425-429
- Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes.Am J Obstet Gynecol. 2005; 192: 1162-1166
- Introduction to categorical data analysis.in: John Wiley, New York1996: 231-236
- Pregnancy outcomes in women with intrauterine device contraceptive failure.Am J Obstet Gynecol. 2005; 193: s111
- Interval insertion of intrauterine device in women with previous cesarean section.Contraception. 1984; 30: 209-214
Article Info
Publication History
Published online: August 31, 2009
Accepted:
June 11,
2009
Received in revised form:
May 19,
2009
Received:
February 26,
2009
Footnotes
Reprints not available from the authors.
Cite this article as: Ganer H, Levy A, Ohel I, et al. Pregnancy outcome in women with an intrauterine contraceptive device. Am J Obstet Gynecol 2009;201:381.e1-5.
Identification
Copyright
© 2009 Published by Elsevier Inc.
