April 4th, 2020

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Probability of Intrauterine Device Perforation in a Tertiary Care Hospital and Its Affiliated Clinics
Authors:  Logan C. Peterson, M.D., Timothy S. Batig, M.D., and Alison L. Batig, M.D.
  OBJECTIVE: To determine the probability of clinically identified and confirmed intrauterine device (IUD) perforations within a tertiary care hospital and its affiliated clinics.

STUDY DESIGN: This was an observational study from a tertiary care center and its affiliated clinics using coding data from our electronic medical record database and a search of descriptive terminology from ambulatory and inpatient electronic records from 2008–2014. We identified the total number of IUD placements and cases of IUD perforation. Using this data, we determined the probability of identified device perforations seen within our patient population per 1,000 placements. Patient and placement variables associated with device perforation were evaluated with descriptive statistics and by comparing relative risk.

RESULTS: We identified 3,959 IUD placements occurring during the study period. During that interval there were 23 cases of IUD perforation. The probability of IUD perforation was 5.8 per 1,000 placements (95% CI 1.2–10.8). There was no significant difference in perforation risk based on the training stage and type or specialty of the provider performing the procedure.

CONCLUSION: In clinical practice, the probability of IUD perforation may be higher than that suggested by prior studies.
Keywords:  contraception; contraceptive devices; contraceptive IUD; copper intrauterine devices; hormone-releasing IUDs; IUD, copper-releasing; IUD, hormone releasing; IUD migration; intrauterine device migration; intrauterine devices; intrauterine devices, medicated; uterine perforation
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