Re: Question for those of you inserting IUDs

From: Dr. Bülent Potur (bpotur@yahoo.com)
Wed Jul 25 03:17:27 2007


Below is a publication when I had found for a case report of mine. An IUD diagnosed in the pouch of Douglas with vaginal ultrasound Dirim Sep-Oct 2002 31-34) The case also was consistent with the majority of the review below. The IUD had been inserted at 6th week post partum to a lactating women. When the uterus was so thin and avascular and prone to perforation The patient had been referred when the strings of the IUD was not seen at check 2.5 months later insertion. Bulent Potur MD Obgyn Kirikkale TURKEY

1: Contraception. 1998 Apr;57(4):251-5.Click here to read Links Perforations with intrauterine devices. Report from a Swedish survey. Andersson K, Ryde-Blomqvist E, Lindell K, Odlind V, Milsom I. Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden. This survey comprised 50 consecutive perforations occurring with intrauterine devices (IUD) reported to the National Patient Insurance Scheme Register during 1990 to 1993. All 50 women were parous and > 20 years of age at the time of IUD insertion. Forty-two (84%) of the IUD were inserted by a midwife and eight by a gynecologist. A total of 45 women (90%) had their IUD inserted < 1 year after a full-term pregnancy and 31 women (62%) had their IUD inserted < or = 12 weeks after delivery. Of the 50 women, 27 (54%) reported that they were breastfeeding at the time of IUD insertion. No particular IUD was overrepresented in relation to its share on the market. In 31 cases (62%), severe pain at insertion and during the first 24 h was recorded. In 14 women (28%), the perforation was diagnosed early (i.e., within 1 month of insertion) and in 36 women (72%), the perforation was diagnosed > 1 month after insertion. Lower abdominal pain was the most frequent
symptom at early diagnosis but in two cases, the main symptom was heavy bleeding. Among the 36 women in whom the perforation was discovered more than 1 month after insertion, the diagnosis was made when an unexpected pregnancy occurred in 20 women (56%). In 15 cases, the IUD strings were not visible during pelvic examination at a routine check-up, which led to efforts to locate the IUD. Thirty-two women (64%) underwent laparotomy for removal. We conclude that lactating women seem to be a risk group for perforation and that a national register of IUD perforations could provide a better means of quality control. PMID: 9649917 [PubMed - indexed for MEDLINE]

At Tue, 24 Jul 2007, GIN11153@aol.com wrote: >
>Friend asked me about perforation rate. I don't have an answer but thought
>that it is an accepted complication that is discussed in an informed consent.
>Your thoughts, please!
>
>Gail Neuman RNC CPHW
>student midwife and student nurse practitioner
>certified high risk OB
>Perinatal Nurse Associates
>801 N. Tustin Ave., Suite 305
>Santa Ana, CA 92705
>(714) 314-7070
>(714) 838-1479 fax
>





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