Intrauterine devices and pelvic inflammatory disease

Abstract

There is convincing clinical evidence that PID is more common in IUD users than in users of other contraceptive methods. There appears to be a smaller but significant increase when IUDs are compared with sexually active noncontraceptive users. However, the incidence of PID severe enough to warrant hospitalization is only of the order of 1 to 2 per 1,000 women per year. The question which remains is whether beyond this low figure of moderate and severe disease there is a much higher incidence of subclinical PID which may result in complications for IUD users. Development of a marker such as C-Reactive protein or the split complement component C3d to detect mild PID would prove invaluable in the elucidation of several crucial problems in the clinical management of women using IUDs.

PIP: There is convincing clinical evidence that pelvic inflammatory disease (PID) is more common in IUD users than in users of other contraceptive methods. There appears to be a smaller but significant increase when IUD users are compared with sexually active noncontraceptive users. However, the incidence of PID severe enough to warrant hospitalization is only of the order of 1-2/1000women/year. The question which remains is whether beyond this low figure of moderate and severe disease there is a much higher incidence of subclinical PID which may result in complications for IUD users. Development of a marker such as C-reactive protein or the split complement componet C3d to detect mild PID would prove invaluable in the elucidation of several crucial problems in the clinical management of women using IUDs.