Ectopic pregnancy during the use of intrauterine contraceptive devices
Pukhov, V.P.; Ul'ianov a, V.N.; Ganina, A.A.
Akusherstvo i Ginekologiia 8: 71
1988
ISSN/ISBN: 0300-9092 PMID: 3195717 Document Number: 316648
The most efficient, convenient, relatively risk-free, and widely used form of contraception is the IUD. However, pregnancies do occur sporadically with this method. The IUD may also provoke interruptions of the menstrual function, disease syndromes, inflammation of the genitals, and be expulsed and cause perforation of the uterus, or be displaced. Literature provides contradictory evidence regarding the development of ectopic pregnancies in connection with the use of IUD, however, a 3.5-4 times higher frequency than for the general population has been reported. 210 operations were performed in the gynecological clinics in Yaroslavl for extrauterine pregnancy during the period 1984-87. For 36 patients (17.1%) an IUD (Lippes loop) was found in the uterine cavity. The majority of the women were in the age group 20-35. All patient except one were multiparous with an average of 1-3 births and from 2 to 5 induced abortions. 6 women had carried the IUD for less than a year, 27 women between 2 and 4 years, 2 women from 4 to 9 years, and 1 woman 11 years. All women were urgently treated and operated on within a few hours of being admitted to the clinics. During laparoscopic tests, 13 women showed rupture of the fallopian tubes with significant bleeding into the abdominal cavity. When the women first consulted the clinic, the diagnosis for most of them was either endometritis, disruption of the menstrual function, or acute adnexitis in connection with use of IUD, and only for 3 of them was an extrauterine pregnancy suspected, since the IUD makes that circumstance unlikely. The postoperative period was uneventful for all patients and they were discharged after 12-16 days. For users of IUD it is concluded that if the menstrual period is skipped and subsequent occurrence of disease symptoms or greasy or bloody excretions occur, the possibility of extrauterine pregnancy should be considered, and the patient should be directed to a gynecological clinic in order to pinpoint the diagnosis and arrange for treatment.