Key result
Among 16 cases of uterine perforation by a copper IUD, 13 occurred following insertion within 5 months postpartum, and all required laparotomy for removal.
Why the study?
What are the clinical characteristics and risk factors associated with uterine perforation by a copper IUD?
Case Report (n=16)
What are the clinical characteristics and risk factors associated with uterine perforation by a copper IUD?
Postpartum insertion of a copper IUD during lactation and uterine involution carries an increased risk of uterine perforation, often presenting as a missing string or painful insertion.
May support caution with early postpartum copper IUD insertion; leaves open prospective studies on lactation and involution risks.
Sixteen cases with uterine perforation by a copper intrauterine device (IUD) are presented. In 13 cases the IUD had been inserted within 5 months following delivery, and in 6 cases the insertion had been painful. Missing string was the first sign in most cases. Laparatomy was performed in all cases to remove the IUD. The IUD was adherent to omentum or sigmoid in 10 cases. There is an increased risk of uterine perforation if the IUD is inserted postpartum during lactation and involution of the uterus. Therefore a painful IUD insertion and a missing string demand investigation of a partial or complete perforation.
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Heinonen et al. (1984) conducted a case report in Uterine perforation (n=16). Copper intrauterine device (IUD) was evaluated on Clinical presentation and management of uterine perforation. Among 16 cases of uterine perforation by a copper IUD, 13 occurred following insertion within 5 months postpartum, and all required laparotomy for removal.
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