BACKGROUND: While intrauterine devices (IUDs) provide highly effective contraception, pregnancies among IUD users do rarely occur. The objective of this systematic review is to assess the evidence about risks for adverse pregnancy outcomes among women who conceive with an IUD in situ. METHODS: We searched MEDLINE, POPLINE, EMBASE and LILACS databases from inception through April 2011 for peer-reviewed articles containing evidence related to pregnancy outcomes among women who conceived while using copper (Cu) and levonorgestrel-releasing (LNG) IUDs. RESULTS: Nine articles met our inclusion criteria. Women with retained IUDs were at the greatest risk of adverse pregnancy outcomes, including spontaneous abortion, preterm delivery, septic abortion and chorioamnionitis. Cu-IUD removal decreased risks but not to the baseline risk of pregnancies without an IUD. One case series examined the LNG-IUD; when left in situ, 8 in 10 ended in spontaneous abortions. CONCLUSION: Pregnancies complicated by a remaining IUD in situ were at greater risk of adverse pregnancy outcomes. Early IUD removal appeared to improve outcomes but did not entirely eliminate risks.
BACKGROUND: While intrauterine devices (IUDs) provide highly effective contraception, pregnancies among IUD users do rarely occur. The objective of this systematic review is to assess the evidence about risks for adverse pregnancy outcomes among women who conceive with an IUD in situ. METHODS: We searched MEDLINE, POPLINE, EMBASE and LILACS databases from inception through April 2011 for peer-reviewed articles containing evidence related to pregnancy outcomes among women who conceived while using copper (Cu) and levonorgestrel-releasing (LNG) IUDs. RESULTS: Nine articles met our inclusion criteria. Women with retained IUDs were at the greatest risk of adverse pregnancy outcomes, including spontaneous abortion, preterm delivery, septic abortion and chorioamnionitis. Cu-IUD removal decreased risks but not to the baseline risk of pregnancies without an IUD. One case series examined the LNG-IUD; when left in situ, 8 in 10 ended in spontaneous abortions. CONCLUSION: Pregnancies complicated by a remaining IUD in situ were at greater risk of adverse pregnancy outcomes. Early IUD removal appeared to improve outcomes but did not entirely eliminate risks.
Authors: Catherine H Phillips; Jeremy R Wortman; Elizabeth S Ginsburg; Aaron D Sodickson; Peter M Doubilet; Bharti Khurana Journal: Emerg Radiol Date: 2017-09-25
Authors: Percy Pacora; Roberto Romero; Offer Erez; Eli Maymon; Bogdan Panaitescu; Juan Pedro Kusanovic; Adi L Tarca; Chaur-Dong Hsu; Sonia S Hassan Journal: J Matern Fetal Neonatal Med Date: 2017-12-27
Authors: Juan P Kusanovic; Roberto Romero; Carolina Martinovic; Karla Silva; Offer Erez; Eli Maymon; Francisco Díaz; Fernando Ferrer; Rafael Valdés; Víctor Córdova; Paula Vargas; María Elena Nilo; Patricio Le Cerf Journal: J Matern Fetal Neonatal Med Date: 2017-05-03