Uterine perforation rates remain low after intrauterine device insertion

Key clinical point: The overall rate of uterine perforation after intrauterine device (IUD) insertion was less than 1%, but higher with placement at 4-8 weeks postpartum compared to 9-36 weeks postpartum.

Major finding:  After adjusting for multiple variables, perforation rates associated with IUDs were significantly higher when placed at 4-8 weeks vs. 9-36 weeks postpartum (0.78% versus 0.46%, P = .001). Expulsion rates were low and similar between the early and late placement groups (1.02 vs. 1.17).

Study details: The data come from a retrospective cohort study of 24,959 women who underwent insertion of an intrauterine device at a single center. A total of 430 patients had confirmed complications; 157 of these were uterine perforations and 273 were intrauterine device expulsions.

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Disclosures: The study received no outside funding. Lead author Dr. Ramos-Rivera had no financial conflicts to disclose. A coauthor is supported by the NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development.

Source: Ramos-Rivera M et al. Am J Obstet Gynecol. 2021 Aug 27. doi: 10.1016/j.ajog.2021.08.028.