Complications of intrauterine contraceptive devices

Abstract

Nearly a decade of experience with the IUD in dozens of countries and with millions of woman has demonstrated that this is a highly effective and valuable method of contraception. Some disappointment has been expressed because of high discontinuation rates in some programs. Some of the common complications are described. Pregnancies occur with the device in utero, or after unnoticed expulsion; significant numbers of women seek removal of the device because of pain and bleeding. Pelvic inflammatory disease and perforation create more serious problems. It does not protect against ectopic pregnancy but at the same time it does not increase the incidence. Fatal sepsis cases associated with midtrimester pregnancies complicated by intrauterine devices have created the most significant and threatening complication to IUD usage. The copper IUD offers promise, but not as much as originally contemplated. It cannot be too strongly emphasized however, that the IUD is no magic genie, whatever its size or shape, guaranteeing complication free, perfect contraception.