Pregnancy outcome with removal of intrauterine device.

Abstract

Of 201 women who became pregnant with an IUD in situ, 120 had the device left inserted and 81 had it removed. Patients excluded from the study were those who showed evidence of threatened or incomplete abortion, those in whom the thread was not visible and the IUD not recovered during or after termination of pregnancy, and those known to have had attempts at induced abortions. The IUDs were removed only when the thread was still visible at the cervical os, when pregnancy was within the first trimester, and when the 1st attempt at pulling the thread offered no undue resistance. 12 weeks gestation was taken as the cut-off period for attempted removal since the conceptus does not fully occupy the uterine cavity until the 4th month. In the group in which the devices, mostly Lippes loops, had been left in situ there were 5 cesarean sections for obstetric indications including 1 case of placenta previa. 2 of the premature infants died during the neonatal period. Among those with the devices left in situ 48.44% aborted, compared wtih 29.62% in the removal group (p less than .02 greater than .01). When the incidence of abortion and prematurity were combined, the in situ group showed a significant increase (p less than .01). The incidence of ectopic pregnancy in this series also confirms previous reports of the relative increase (5%) among women who become pregnant with the IUD in situ. In this series of incidence was 6%. These data suggest that when continuation of pregnancy is desired, the IUD should be removed if possible.