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  • Title: The risk of pelvic inflammatory disease in women using intra-uterine device--a prospective study at the Kenyatta National Hospital.
    Author: Abdulla SH.
    Journal: J Obstet Gynaecol East Cent Africa; 1982 Dec; 1(4):156-8. PubMed ID: 12313676.
    Abstract:
    This study is designed to find out 1) whether the use of intrauterine device (IUD) is a factor in pelvic inflammatory disease (PID); 2) the time interval between insertion of IUD and the diagnosis of PID, and 3) the relationship between the onset of PID and the last mentrual period among IUD users. The use of IUD in 147 patients treated at the Gynaecological Unit of the Kenyatta National Hospital for PID was compared with the use in a sexually active age, parity matched control group. 34% of the patients and 7.5% of the controls were using IUD. Thus the relative risk of developing PID was shown to increase by 4.5 with IUD use. More than 1/2 the PID cases (68%) were between the age group of 21-30 years, the same group as the majority of IUD users. Among the IUD users with PID 56% developed the disease withing the 1st week of the last mentrual period and 78% within 2 weeks of menses. Only 8% of the cases developed PID withing 3 months of IUD insertion; 50% of the cases had been using the device for a year. Oral contraceptives were being used by more controls (33%) than patients (7.5%). Among nulliparous patients and controls, no correlation could be elicited between IUD use and PID development, as in both groups no one had used IUD. There were 147 (82.6%) parous and 31 (17.4%) nulliparous PID patients. Parous women suffered from PID 4.7 times more than nulliparous women. It is proposed that the excessive and irregular bleeding that often accompanies IUD wearing makes certain women vulnerable to PID long after the risk that attends the immediate post-insertion period.
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