Outcome of Pregnancy in Women Using an Intrauterine Device

Vessey, Martin; Doll, Richard; Johnson, Bridget; Pető, Richárd

doi:10.1016/s0140-6736(74)92798-6

Cited by 75 publications

(13 citation statements)

References 2 publications

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“…In a prospective study Vessey and co-workers have reported a ratio of ectopic pregnancy of 8.9% among IUD users [9]; this is similar to the 7.8% found in this study. Two hospital-based studies have shown lower frequencies of ectopic pregnancies among women experiencing an IUD failure, 3.4% and 1.5%, respectively [5,10].…”

Section: Discussionsupporting

confidence: 89%

Outcomes of pregnancy with an IUDin situ — a population based case — control study

Skjeldestad

Hammervold²,

Peterson³

1988

Adv Contracept

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Use of IUDs was examined among 962 women whose pregnancy was terminated at the University Hospital of Trondheim, Norway during 1983. Ectopic pregnancy was significantly more often diagnosed among women with an IUD in place at conception compared to non-users (7.8% vs 1.3%, p less than 0.01). Despite removal of the IUD during the first trimester, women who became pregnant with an IUD in situ had spontaneous abortion more often than non-users (15.6% vs 7.0%, p less than 0.05). The causal significance of these findings will require further investigation. The small number of ectopic pregnancies subsequent to an IUD contraceptive failure in relation to the number of all pregnancies within the same time frame may explain the lack of a demonstrable link between increasing IUD use and increasing rates of ectopic pregnancy.

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Section: Discussionsupporting

confidence: 89%

Outcomes of pregnancy with an IUDin situ — a population based case — control study

Skjeldestad

Hammervold²,

Peterson³

1988

Adv Contracept

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“…It has long been known that the spontaneous abortion rate is high when a pregnancy occurs in the presence of an IUD. 15 Although the risk of ectopic pregnancy is extremely low with the LNG IUS, it can nevertheless occur, as in the present study and others. [16][17][18] The expulsion rate and the removal for PID rates were low and there were no perforations.…”

Section: Discussionsupporting

confidence: 73%

Clinical performance of the levonorgestrel intrauterine system in routine use by the UK Family Planning and Reproductive Health Research Network: 5-year report

Cox¹,

Tripp²,

Blacksell³

2002

j fam plann reprod health care

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Objectives. This study was undertaken to determine the performance of the levonorgestrel intrauterine system (LNG IUS) IntroductionThis report concludes the study of which the 12-month and 24-month results have been published. 1,2 The concept of intrauterine administration of a progestin-only contraceptive as an alternative to oral, parenteral or subdermal implants was first considered in 1970. 3 Experiments with various slow-release membranes and intrauterine contraceptive device (IUD)-carrying frames resulted in the development of an intrauterine system (IUS) releasing levonorgestrel, now marketed as Mirena ® which was introduced in Finland in 1990 and in the UK in May 1995.Very low pregnancy rates have been reported, between 0.5 and 1.1 cumulative gross rates per 100 users at 5 years [4][5][6] (Table 1). Expulsion rates have been similar to that of other IUDs. The Mirena ® is recommended for use up to 5 years, although very low pregnancy rates have also been reported after up to 7 years of use. 7 The endometrium remains atrophic while the levonorgestrel is at a sufficient level to suppress it, 8 and therefore changes in menstrual patterns are likely to occur. Sivin and Stern, 9 reporting a multicentre study, commented that 'menstrual patterns during contraception were radically altered by the LNG'.Several randomised trials have found that discontinuation rates because of heavy or prolonged menstrual blood flow were significantly lower with the LNG IUS than with copper IUDs. 10 Sivin et al. 11 found that discontinuation attributable to amenorrhoea was the principal contributor to differences in continuation rates between the LNG IUS and the Cu T380A ® IUD.There is a need to determine the performance of the LNG IUS in British women with particular regard to the nature and incidence of side effects. Methods Key message pointsAt 5 years of use the LNG IUS (Mirena ® ) has been shown to have a very low pregnancy rate and a low expulsion rate. The rate for removal for complaints of bleeding problems was high during the first year. There is a need for careful counselling before fitting to prepare women for changes in bleeding patterns during the first 12 months of use. Removals were also required for side effects that may be due to absorbed levonorgestrel. The reductions in duration and quantity of periods in many women were significant advantages.

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“…It has long been known that the spontaneous abortion rate is high when a pregnancy occurs in the presence of an IUD. 14 The results of the present study are comparable to other studies except that the removal rates for bleeding and bleeding with pain are higher. The reason for this is not obvious.…”

supporting

confidence: 88%

Clinical performance of the levonorgestrel intra-uterine system in routine use by the UK Family Planning and Reproductive Health Research Network: 12-month report

Cox

Blacksell

2000

j fam plann reprod health care

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Outcome of Pregnancy in Women Using an Intrauterine Device

Cited by 75 publications

References 2 publications

Outcomes of pregnancy with an IUDin situ — a population based case — control study

Outcomes of pregnancy with an IUDin situ — a population based case — control study

Clinical performance of the levonorgestrel intrauterine system in routine use by the UK Family Planning and Reproductive Health Research Network: 5-year report

Clinical performance of the levonorgestrel intra-uterine system in routine use by the UK Family Planning and Reproductive Health Research Network: 12-month report

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