Evaluation of Risk Factors for Uterine Perforation when Using an Intrauterine Device

Abstract

As one of the most popular methods of contraception, intrauterine devices (IUDs) are currently used across the world and uterine perforation has been presented among the most significant potential complications of IUD use, which commonly occurs during its insertion rather than delayed migration. Method: In this retrospective study, two groups of women in need of surgery for misplaced IUD retrieval were investigated. The patients in the first group underwent surgery to remove the dislocated intra-abdominal device and received appropriate treatment for its complications such as visceral injury. In the second group, the patients underwent surgery only for removing the lost misplaced device embedded in the myometrium without uterine perforation. Results: The study findings revealed that the less inexperience of healthcare providers for IUD insertion and scheduled follow-up visits along with misinterpretation of invisible IUD strings, improper patient selection regarding the structural disorders based on sonographic studies, loss of post insertion ultrasound study to evaluate the proper IUD placement as the most important factors affecting the occurrence of uterine perforation (P<0.05). Abdominal pain was the most common compliant of uterine perforation and laparoscopy was the most used surgery to remove the ectopic intra-abdominal device (P<0.05). Ectopic pregnancy was the most frequent pregnancy outcome with undiagnosed uterine perforation.