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. 2017 Jun;95(6):605-607.
doi: 10.1016/j.contraception.2017.03.007. Epub 2017 Mar 16.

IUD use among parous women and risk of uterine perforation: a secondary analysis

Klaas Heinemann  1 , Clare Barnett  2 , Suzanne Reed  2 , Sabine Möhner  2 , Thai Do Minh  2
Affiliations

IUD use among parous women and risk of uterine perforation: a secondary analysis

Klaas Heinemann et al. Contraception. 2017 Jun.

Abstract

Objective: The objective of the study was to determine if delivery and lactation are risk factors for complete intrauterine device perforations.

Study design: We performed a reanalysis of the European Active Surveillance Study on Intra-Uterine Devices data set using complete penetration of the myometrium as the definition for perforation.

Results: Of the 61,448 women enrolled (70% levonorgestrel, 30% copper devices), we identified 58 complete perforations, 30 of which occurred in lactating women. Incidence per 1000 insertions was 4.5 (95% confidence interval [CI]: 3.0-6.4) for lactating and 0.6 (95% CI: 0.4-0.9) for nonlactating women. Time since delivery was also associated with perforation risk.

Conclusions: Lactation and delivery are independent cofactors for perforation. Results do not differ when restricting the definition of perforation.

Keywords: Active surveillance; Breastfeeding; Childbirth; IUD; Levonogestrel; Prospective cohort study.

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