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  • Title: The intrauterine device and deaths from spontaneous abortion.
    Author: Cates W, Ory HW, Rochat RW, Tyler CW.
    Journal: N Engl J Med; 1976 Nov 18; 295(21):1155-9. PubMed ID: 980018.
    Abstract:
    To evaluate the intrauterine device as a risk factor for mortality associated with spontaneous abortion, we analyzed all deaths from spontaneous abortions reported in the period 1972-1974. Women dying from spontaneous abortions with a device in place were more likely to be young, white and married than those not wearing a device. Risk of death from spontaneous abortion was over 50 times greater for women who continued their pregnancy with a device in place than for those who did not. The Dalkon shield carried an increased risk of death, as compared to other devices, even after rates were adjusted for duration of use. However, pregnant women with either a loop or a coil in place also had a higher risk of dying from spontaneous abortion than those without any device. The results support the clinical recommendation that any device should be removed when pregnancy is first diagnosed. Data on deaths from spontaneous abortion in the U.S. during 1972-1974 were analyzed to assess the IUD as a contributing factor. 50 deaths from spontaneous abortion were reported for the 3-year period, 17 of which were associated with an IUD in place during pregnancy. Those dying from spontaneous abortion with an IUD in place tended to be young, white, and married. The mortality risk from spontaneous abortion was more than 50 times as great in patients who continued their pregnancy with an IUD in place than those who did not. Compared with other devices, the Dalkon Shield IUD was associated with an increased risk of death from spontaneous abortion. The findings support the recommendation that an IUD be removed once pregnancy is confirmed.
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