Intrauterine pregnancies conceived in the presence of intrauterine devices (IUD): a single center experience

Abstract

Aim: This study aims to investigate the clinical and perinatal outcomes of pregnancies occurring in the presence of an intrauterine device (IUD). Material and Method: A total of 132 women diagnosed as having pregnancies complicated by IUDs in situ with visible strings were retrospectively examined during a period of six years. Twenty-nine women who chose to keep their IUDs in situ during pregnancy were included in Group 1 whereas 103 women who had their IUDs removed during pregnancy were included in Group 2. Results: Age, parity, frequency of IUD insertion at a maternity hospital and frequency of IUDs located within the uterine corpus were significantly higher in women who retained their IUDs compared to women who had their IUDs removed (p=0.02, p=0.04, p=0.02 and p=0.01, respectively). Although women who retained their IUDs had a significantly higher frequency of perinatal complications, they had a higher gestational week at delivery as well as higher Apgar scores at both 1 and 5 minutes (p=0.01, p=0.02 and p=0.02, respectively). Gestational age at preterm delivery was significantly lower in women who retained their IUDs during pregnancy (31.4 +/- 6 weeks vs. 33.0 +/- 4 weeks, p=0.01). Conclusion: Although removing IUDs with visible strings during pregnancy may increase the abortion risk, retaining them is also associated with adverse perinatal outcomes such as preterm premature rupture of membranes and preterm delivery. If an IUD located within the uterine cavity is retained during pregnancy, it may act as a filter allowing pregnancies to reach term.