Risk factors of uterine perforation when using contraceptive intrauterine devices.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

BMC Women's Health Pub Date : 2024-09-27 DOI:10.1186/s12905-024-03298-3

Fatemeh Tabatabaei, Seyedeh Tala Nabipour Hosseini, Parvin Hakimi, Razieh Vejdani, Bahareh Khademi

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引用次数: 0

Abstract

Background: Intrauterine devices (IUDs) are one of the most popular methods of contraception, and uterine perforation has been presented among the most significant potential complications of IUD use. The aim of this study is to evaluate the risk factors of uterine perforation when using an IUD.

Methods: In this retrospective study, all 164 women who have referred to Al-Zahra hospital in Tabriz- Iran to remove the retained IUD from March 2018 to March 2021, were investigated in two groups. Patients in case group underwent surgery to remove the dislocated device and management of its complications. In control group, the devices were removed using a Novak or ring forceps with or without hysteroscopy with no uterine perforation. Data were analyzed using SPSS software, and P < 0.05 was considered statistically significant. P-Value was obtained for qualitative data via Fisher's exact test and Chi-Squared test and for quantitative data via Mann-Whitney U test and independent T-test.

Results: The mean age of patients in the groups with or without uterine perforation was 30.57 and 36.78 years respectively (P = 0.01). The frequency of two or more parities among patients with uterine perforation was higher than other patients (P = 0.13). Ultrasound study before (p = 0.037) and after (p = 0.007) IUD insertion was higher among patients without uterine perforation. The less inexperience of healthcare providers (P = 0.013) and lack of scheduled follow-up visits after the IUD insertion (P < 0.001), are the other important factors affecting the uterine perforation. Abdominal pain was the most common compliant of uterine perforation (P < 0.001) and laparoscopy was the most used surgery to remove the misplaced device.

Conclusion: Uterine perforation can be effectively prevented by hiring experienced health care providers and appropriate patient selection.

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背景：宫内节育器（IUD）是最流行的避孕方法之一，子宫穿孔是使用宫内节育器最重要的潜在并发症之一。本研究旨在评估使用宫内节育器时发生子宫穿孔的风险因素：在这项回顾性研究中，对 2018 年 3 月至 2021 年 3 月期间转诊至伊朗大不里士 Al-Zahra 医院取出滞留宫内节育器的所有 164 名妇女进行了调查，分为两组。病例组患者接受手术，取出脱位的节育器并处理其并发症。在对照组中，使用诺瓦克钳或环形钳取出装置，无论是否进行宫腔镜检查，均未发生子宫穿孔。数据使用 SPSS 软件进行分析，P 结果：有或无子宫穿孔组患者的平均年龄分别为 30.57 岁和 36.78 岁（P = 0.01）。子宫穿孔患者两次或多次分娩的频率高于其他患者（P = 0.13）。未发生子宫穿孔的患者在放置宫内节育器前（P = 0.037）和放置宫内节育器后（P = 0.007）进行超声检查的比例较高。医护人员的经验较少（P = 0.013），宫内节育器放置后没有按计划进行随访（P 结论：子宫穿孔可以通过宫腔镜检查来治疗：通过聘用经验丰富的医护人员和适当选择患者，可有效预防子宫穿孔。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Women's Health OBSTETRICS & GYNECOLOGY-

CiteScore

3.40

自引率

4.00%

发文量

444

审稿时长

>12 weeks

期刊介绍： BMC Women''s Health is an open access, peer-reviewed journal that considers articles on all aspects of the health and wellbeing of adolescent girls and women, with a particular focus on the physical, mental, and emotional health of women in developed and developing nations. The journal welcomes submissions on women''s public health issues, health behaviours, breast cancer, gynecological diseases, mental health and health promotion.