Intrauterine devices used currently
Mall-Haefeli, M.
Medizinische Monatsschrift für Pharmazeuten 2(4): 109-116
1979
ISSN/ISBN: 0342-9601 PMID: 554943 Document Number: 143745
A literature review of modern IUDs is presented. The larger the IUD, the more effective it is, but the rate of side effects also increases with the size. The Pearl Index for IUDs is presently .5-1.5. IUD use is indicated if hormonal contraceptive use is contraindicated. Many factors are involved in the effectiveness of IUDs. IUD use causes an increase in the number of macrophages and neutrophils, in IgG and IgM levels, and alkalic phosphatase and local fibrinolytic activity in the endometrium. The effectiveness of IUDs is enhanced by impregnating them with copper or outfitting them with a system to release progesterone. The abortion rate with IUD in situ ranges from about 50% for an inert IUD to nearly 60% for IUDs with active substances. Spontaneous abortions are twice as frequent with IUDs in situ, 3/4 of which occur in the first trimester. The rate of ectopic pregnancy with IUD in situ ranges from 2.9-9%. The expulsion rate is reported between 3 to 15/100 women-years. Bleeding, pain, and genital infection are other side effects of IUD use. The rate of perforation has been reported between 1:350 and 1:2500, depending on the type of IUD. IUDs are contraindicated if pregnancy is suspected, if any serious genital or pelvic infections or bleeding are present, if there are irregularities in the shape of the cervix or uterus, or if there is a history of extrauterine pregnancy or a suspicion of genital cancer.