Abstract
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.
Keywords
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Article info
Publication history
Published online: August 17, 2011
Accepted:
June 23,
2011
Received in revised form:
June 16,
2011
Received:
April 12,
2011
Footnotes
☆The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the World Health Organization or the Centers for Disease Control and Prevention.
☆☆This review was supported by resources from the Department of Reproductive Health and Research at the World Health Organization, the Centers for Disease Control and Prevention, an Anonymous Foundation, and the National Institute of Child Health and Human Development, USA.
Identification
Copyright
© 2012 Published by Elsevier Inc.
