A RETROSPECTIVE EVALUATION OF THE IUD IN A BUENOS AIRES PATIENT POPULATION
ESC Congress Library. Jagroep S. 05/28/14; 50560; A-145
Sherani Jagroep
Sherani Jagroep
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Abstract
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Introduction: There are approximately 222 million women with an unmet need for contraception in developing countries worldwide. These women account for approximately 82% of all unintended pregnancies. Access to effective modern contraception is vital in meeting family planning needs as it reduces unintended pregnancies and may prevent pregnancy related deaths and disabilities. The intrauterine device (IUD) is recognized as one of the best contraceptive methods by virtue of its efficacy and extended period of use. It remains underutilized due to false perceptions and lack of information by both the public and providers. Regardless of some widespread resistance, the device is a popular form of contraception in an Argentinian family planning clinic. (Planificación Familiar del Hospital Bernardino Rivadavia; Buenos Aires, Argentina). Objectives: The aims of this study were to assess long-term performance of the IUD and describe patient experiences with the device. Methods: A retrospective evaluation of 1,050 IUD insertions between 2002 and 2007 with a follow up of five years. Rates of removal were assessed using survival analyses and reasons for removal using bivariate analyses. Both a logistic regression model and a cox proportional hazard model were created to assess the correlation of IUD-depth (distance measured in millimeters from the device to the fundus of the uterus) with adverse outcomes such as IUD removal and symptoms of pain. Results: The main reasons for IUD removal were the IUD descending, wanting pregnancy and wanting another form of birth control. A survival analysis found only 16% of women removed the IUD within five years and IUD discontinuation was greater for first time IUD recipients compared to former recipients. Furthermore, women with greater IUD depths were more likely to have their IUD descended or removed compared to women with an average IUD depth: A cox proportional hazard model reveals that women were 83% more likely to have their IUD removed. Conclusion: This study encourages providers serving similar populations to recognize the IUD as a reliable alternative of contraception as it’s efficacy is supported through overall good long-term performance and minimal adverse outcomes. Furthermore, IUD depth should be assessed more frequently as it may be indicative of an IUD descending or expelling.

Introduction: There are approximately 222 million women with an unmet need for contraception in developing countries worldwide. These women account for approximately 82% of all unintended pregnancies. Access to effective modern contraception is vital in meeting family planning needs as it reduces unintended pregnancies and may prevent pregnancy related deaths and disabilities. The intrauterine device (IUD) is recognized as one of the best contraceptive methods by virtue of its efficacy and extended period of use. It remains underutilized due to false perceptions and lack of information by both the public and providers. Regardless of some widespread resistance, the device is a popular form of contraception in an Argentinian family planning clinic. (Planificación Familiar del Hospital Bernardino Rivadavia; Buenos Aires, Argentina). Objectives: The aims of this study were to assess long-term performance of the IUD and describe patient experiences with the device. Methods: A retrospective evaluation of 1,050 IUD insertions between 2002 and 2007 with a follow up of five years. Rates of removal were assessed using survival analyses and reasons for removal using bivariate analyses. Both a logistic regression model and a cox proportional hazard model were created to assess the correlation of IUD-depth (distance measured in millimeters from the device to the fundus of the uterus) with adverse outcomes such as IUD removal and symptoms of pain. Results: The main reasons for IUD removal were the IUD descending, wanting pregnancy and wanting another form of birth control. A survival analysis found only 16% of women removed the IUD within five years and IUD discontinuation was greater for first time IUD recipients compared to former recipients. Furthermore, women with greater IUD depths were more likely to have their IUD descended or removed compared to women with an average IUD depth: A cox proportional hazard model reveals that women were 83% more likely to have their IUD removed. Conclusion: This study encourages providers serving similar populations to recognize the IUD as a reliable alternative of contraception as it’s efficacy is supported through overall good long-term performance and minimal adverse outcomes. Furthermore, IUD depth should be assessed more frequently as it may be indicative of an IUD descending or expelling.

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