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  • Title: Complications associated with IUD use in a family practice setting.
    Author: Lewis RD, Shank C.
    Journal: J Fam Pract; 1979 Jan; 8(1):47-52. PubMed ID: 759549.
    Abstract:
    This study compares the complication rate of intrauterine contraceptive devices (IUD) with other contraceptive measures in a residency practice. The study population included 220 randomly selected women who had IUDs inserted by residents over a five-year period. One hundred similarly selected women started on birth control pills (BCP) were used as a control group. Of the IUD patients, 8.6 percent developed pelvic inflammatory disease vs 2 percent of the BCP patients. The incidence of gonorrhea was not significantly different between the two groups: 8.2 percent for the IUD groups vs 7 percent for the BCP group. Discontinuation of IUDs for reasons other than desiring pregnancy was significantly higher than discontinuation of BCPs: 41 percent vs 12 percent. Of the total IUD insertions, there were 21 expulsions (10 percent) and one uterine perforation (0.4 percent). Five pregnancies occurred in the IUD group, yielding a pregnancy rate of 1.7 per 100 women-years. There was a four percent rate of gynecologic hospitalizations in the IUD group as contrasted with one percent rate in BCP group. IUD use in the family practice setting under study is associated with comparatively poor long-term acceptance and a relatively high rate of complications. A study was conducted to define IUD complication and discontinuation rates among a family practice residency patient population. The study group included 220 randomly selected IUD acceptors and a control group of 100 similarly selected pill acceptors. The rate of pelvic pain and bleeding found in this study were comparable to results of other IUD studies; both were causes of IUD discontinuation. The difference between the 8.6% pelvic inflammatory disease rate among IUD patients and the 2% rate in pill patients was highly significant. 4% of the IUD users, compared to only 1% of the pill users, required gynecologic/obstetric-related hospitalization during the study period. Most of these hospitalizations were for serious conditions and most were at least partially related to IUD use. Both the discontinuation and complication rates for IUDs were found to be high enough that the method is not recommended for young, otherwise healthy women without careful consideration of the alternatives available.
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