Uterine perforation on intrauterine device insertion: is the incidence higher than previously reported?

Harrison‐Woolrych, Mira; Ashton, John C.; Coulter, David M.

doi:10.1016/s0010-7824(02)00417-1

Cited by 150 publications

(130 citation statements)

References 7 publications

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“…9 In present study one case of perforation into the uterine wall was observed during interval IUCD insertion and CuT was removed in the same sitting. 10 The removal of IUCD due to bleeding complaints was more in interval IUCD (57%) than in PPIUCD patients (18%). This may be due to the fact that many PPIUCD patients were in the period of lactational amenorrhea and hence there was reduced perception of bleeding.…”

Section: Discussionmentioning

confidence: 93%

Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

Manimegalai

Suganthi

2017

Int J Reprod Contracept Obstet Gynecol

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Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

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Section: Discussionmentioning

confidence: 93%

Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

Manimegalai

Suganthi

2017

Int J Reprod Contracept Obstet Gynecol

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“…Laparoscopy, laparotomy, and now endoscopy have been successfully used to remove misplaced IUCDs: the latter, especially for removal from lower rectum and colon [6,9,10]. This is recommended because of the potential for bowel perforation or intestinal obstruction [1,11,12]. The benefit of an endoscopic approach as first-line therapy is the avoidance of an operation that could require extensive dissection to the lower rectum with risk of injury to pelvic nerves and vasculature [13].…”

Section: Discussionmentioning

confidence: 99%

Transanal Removal of Misplaced Intrauterine Contraceptive Device

Shamikhaa¹,

Makkib²

2017

Natl. j. health sci.

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Intrauterine contraceptive devices are among the most effective forms of contraceptives worldwide. However few complications have been associated with it including uterine perforation which may lead to bowel injury. This is a case of 34-year-lady who had Intra Uterine Copper Device (IUCD) placed 6 years ago. She presented with feeling of strings of IUCD through anus, low backache, and non-cyclical bleeding per rectum for last four months. On sigmoidoscopy, a Copper-T Device was found lodged in anterior rectal wall, which was successfully removed with mild traction transanally. A simple clinical examination i.e digital rectal examination followed by proctosigmoidoscopy, diagnosed and led to complete treatment of the patient, with no post-operative complications.

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“…Uterine perforation is rare but a potentially serious complication with an incidence of less than one case per 1000 insertion and can cause severe morbidity [1].…”

Section: Introductionmentioning

confidence: 99%