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

Abstract

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.

The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD)

“…Several studies have reported a higher rate of miscarriage in women who conceive an intrauterine pregnancy despite the presence of an IUD [18, 48, 52]. Moreover, the present study showed a higher rate of fetal death.…”

“…Several studies have established a higher risk of complications, such as miscarriage and sepsis, in pregnancies with a retained IUD than in those with early IUD removal [2, 18, 48, 52]. For this reason, the U.S. Food and Drug Administration (FDA) recommends that IUDs whose tails are visible be removed in early pregnancy [17].…”

“…Compelling evidence has demonstrated that pregnancies with an IUD are associated with an increased risk of spontaneous abortion and preterm delivery due to infection [2, 52], and the risk of maternal septic complications also increases in such cases [18]. It has been reported that the miscarriage rate is reduced if the IUD is removed in early pregnancy [18, 48, 52], and it is recommended that the IUD should be removed during the first trimester of pregnancy [17]. However, if the IUD remains in the uterine cavity during pregnancy, the management of such pregnancies poses a clinical challenge.…”

Comparison of C-reactive protein levels in pregnancies with retained and removed intrauterine device

“…Our results showed that pregnancies with retained IUD had a higher rate of complications, such as miscarriage, PROM, preterm birth, C-section, and shorter gestational age at delivery in comparison to pregnancies with removed IUD. This was consistent with previous studies [11][12][13][14]. A higher proportion of neonates born to mothers with retained IUD were admitted to NICU than that of those removed IUD, but this was not statistically significant.…”

Practice Bulletin No. 121: Long-Acting Reversible Contraception: Implants and Intrauterine Devices

“…Most reports about complications date from the 1970s and 1980s, and suggest an increased risk of miscarriage, with a higher loss rate if a copper IUD is retained (62,63) than if it is removed (64). Most reports about complications date from the 1970s and 1980s, and suggest an increased risk of miscarriage, with a higher loss rate if a copper IUD is retained (62,63) than if it is removed (64).…”