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Title: IUDs: current perspectives. Author: Hepburn S. Journal: Curr Ther (Seaforth); 1994 Oct; 35(10):49-55. PubMed ID: 12319352. Abstract: Intrauterine devices (IUDs) have been under much adverse media publicity and many product liability lawsuits have been filed since the mid-1970s, when reports of the association of the Dalkon Shield with septic abortion and pelvic inflammatory disease (PID) surfaced. Yet, worldwide, it is estimated that 70 million women are using IUDs (50 million in China). In Scandinavia they are the most popular form of contraception. An international meeting on the current status of IUDs in New York in 1992 concluded that the IUD is a safe and excellent method of contraception for many women. The newest devices, such as Copper TCu380A and the Multiload Cu375, are the most effective. The risk of PID compared with women using no contraception is elevated by a factor of 7.02 only within the first 20 days after IUD insertion. In Norway, where around 40% of women use IUDs, there has been no increase in subfertility rates compared with the US and UK. A large WHO multicenter study in 1989 found that IUD users were 50% less likely to experience ectopic pregnancy than women using no contraception (90% with Copper TCu 380A). The risk of spontaneous abortion is more than doubled and the risks of preterm delivery increased 10-13% with an IUD in situ; therefore, IUDs should be removed as soon as pregnancy is confirmed. If uterine perforation by the device is suspected, it should be located by ultrasound or x-ray and promptly removed. After contraceptive counselling, even experienced general practitioners can insert IUDs at any time during the menstrual cycle, after induced abortion, or complete spontaneous abortion. Heavy menstrual loss or dysmenorrhea are the most common reasons for removing IUDs. Partial or complete IUD expulsion by uterine contractions is most likely during the first 3 months after insertion. Infection should be suspected in any user who develops pelvic pain.[Abstract] [Full Text] [Related] [New Search]