IUD use among parous women and risk of uterine perforation: a secondary analysis.

OBJECTIVE

The objective of the study was to determine if delivery and lactation are risk factors for complete intrauterine device perforations.

STUDY

DESIGN

We performed a reanalysis of the European Active Surveillance Study on Intra-Uterine Devices data set using complete penetration of the myometrium as the definition for perforation.

RESULTS

Of the 61,448 women enrolled (70% levonorgestrel, 30% copper devices), we identified 58 complete perforations, 30 of which occurred in lactating women. Incidence per 1000 insertions was 4.5 (95% confidence interval [CI]: 3.0-6.4) for lactating and 0.6 (95% CI: 0.4-0.9) for nonlactating women. Time since delivery was also associated with perforation risk.

CONCLUSIONS

Lactation and delivery are independent cofactors for perforation. Results do not differ when restricting the definition of perforation.